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Treatment of venous thromboembolism in cancer patients with dalteparin for up to 12 months: the DALTECAN Study.
Francis, C W; Kessler, C M; Goldhaber, S Z; Kovacs, M J; Monreal, M; Huisman, M V; Bergqvist, D; Turpie, A G; Ortel, T L; Spyropoulos, A C; Pabinger, I; Kakkar, A K.
Afiliação
  • Francis CW; University of Rochester Medical Center, Rochester, NY, USA.
  • Kessler CM; Georgetown University Hospital, Washington, DC, USA.
  • Goldhaber SZ; Brigham and Women's Hospital, Boston, MA, USA.
  • Kovacs MJ; London Health Sciences Centre, London, Ontario, Canada.
  • Monreal M; Hospital Universitari Germans Trias i Pujol, Carretera de Canyet, Barcelona, Spain.
  • Huisman MV; Leiden University Medical Center, Leiden, the Netherlands.
  • Bergqvist D; University Hospital, Uppsala, Sweden.
  • Turpie AG; Hamilton Health Sciences, McMaster University, Hamilton, ON, Canada.
  • Ortel TL; Duke University Medical Center, Durham, NC, USA.
  • Spyropoulos AC; University of Rochester Medical Center, Rochester, NY, USA.
  • Pabinger I; Medical University of Vienna, Wien, Austria.
  • Kakkar AK; Barts and The London Queen Mary's School of Medicine and Dentistry, London, UK.
J Thromb Haemost ; 13(6): 1028-35, 2015 Jun.
Article em En | MEDLINE | ID: mdl-25827941
BACKGROUND: Treatment of venous thromboembolism (VTE) in patients with cancer has a high rate of recurrence and bleeding complications. Guidelines recommend low-molecular-weight heparin (LMWH) for at least 3-6 months and possibly indefinitely for patients with active malignancy. There are, however, few data supporting treatment with LMWH beyond 6 months. The primary aim of the DALTECAN study (NCT00942968) was to determine the safety of dalteparin between 6 and 12 months in cancer-associated VTE. METHODS: Patients with active cancer and newly diagnosed VTE were enrolled in a prospective, multicenter study and received subcutaneous dalteparin for 12 months. The rates of bleeding and recurrent VTE were evaluated at months 1, 2-6 and 7-12. FINDINGS: Of 334 patients enrolled, 185 and 109 completed 6 and 12 months of therapy; 49.1% had deep vein thrombosis (DVT); 38.9% had pulmonary embolism (PE); and 12.0% had both on presentation. The overall frequency of major bleeding was 10.2% (34/334). Major bleeding occurred in 3.6% (12/334) in the first month, and 1.1% (14/1237) and 0.7% (8/1086) per patient-month during months 2-6 and 7-12, respectively. Recurrent VTE occurred in 11.1% (37/334); the incidence rate was 5.7% (19/334) for month 1, 3.4% (10/296) during months 2-6, and 4.1% (8/194) during months 7-12. One hundred and sixteen patients died, four due to recurrent VTE and two due to bleeding. CONCLUSION: Major bleeding was less frequent during dalteparin therapy beyond 6 months. The risk of developing major bleeding complications or VTE recurrence was greatest in the first month of therapy and lower over the subsequent 11 months.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Dalteparina / Tromboembolia Venosa / Anticoagulantes / Neoplasias Tipo de estudo: Clinical_trials / Diagnostic_studies / Etiology_studies / Guideline / Observational_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged País/Região como assunto: America do norte / Europa Idioma: En Revista: J Thromb Haemost Ano de publicação: 2015 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Dalteparina / Tromboembolia Venosa / Anticoagulantes / Neoplasias Tipo de estudo: Clinical_trials / Diagnostic_studies / Etiology_studies / Guideline / Observational_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged País/Região como assunto: America do norte / Europa Idioma: En Revista: J Thromb Haemost Ano de publicação: 2015 Tipo de documento: Article