Treatment and Prophylaxis of Venous Thromboembolism in Patients with Cancer Including Patients with COVID-19

Publication Date: July 1, 2022
Last Updated: July 19, 2022

Treatment of incidental or symptomatic established VTE in patients with cancer

Initial treatment of established VTE (up to 10 days of anticoagulation)

Low-molecular-weight heparin (LMWH) is recommended for the initial treatment of established VTE in patients with cancer when creatinine clearance is ≥30 mL/min. (A, 1)
Values and preferences: LMWH is easier to use than unfractionated heparin. A regimen of LMWH, taken once per day, is recommended, unless a twice-per-day regimen is required because of patients’ characteristics (eg, risk of bleeding or moderate renal failure) or the need for technical intervention (eg, surgery or changing regimen). When a twice-per-day regimen is required, only enoxaparin (1 mg/kg, twice-daily) can be used.
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Prophylaxis of VTE in patients with cancer

Prophylaxis of VTE in surgically-treated patients with cancer

Use of low-molecular-weight-heparin (LMWH) once per day (when creatinine clearance is ≥30 mL/min) or low-dose unfractionated heparin three times per day is recommended to prevent postoperative VTE in patients with cancer; pharmacological prophylaxis should be started 2–12 h preoperatively and continued for at least 7–10 days; there are no data allowing conclusions regarding the superiority of one type of LMWH over another. (A, 1)
Values and preferences: LMWH once per day is more convenient.
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Overview

Title

Treatment and Prophylaxis of Venous Thromboembolism in Patients with Cancer Including Patients with COVID-19

Authoring Organization