Onkológia 5/2023

Venous thromboembolism in oncology

Venous thromboembolism in an oncological patient (CaVTE), consisting of deep vein thrombosis (DVT) and/or pulmonary embolism (PE), represents a major clinical challenge in oncology. Oncological patients have a higher risk of VTE compared to the general population, but they also have a higher risk of bleeding, thus complicating the choice of the optimal prevention/treatment. In primary prevention, the recommendations of the international societies have recently changed, whereby patients with a Khorana score of 2 or higher can receive thromboprophylaxis with apixaban, rivaroxaban or low- molecular heparin (LMWH). Direct oral anticoagulants (DOACs)- apixaban, edoxaban and rivaroxaban have also been added to the treatment as an option for oncological patients The optimal choice of anticoagulant for the prevention or treatment of CaVTE requires a multidisciplinary approach, while the patient should also be involved in the decision-making and the risk-benefit ratio should be regularly reassessed.

Keywords: venous thromboembolism, low-molecular heparin, direct oral anticoagulants, oncological patients