Cancer-associated thrombosis: enhanced awareness and pathophysiologic complexity.
Review published in Journal of thrombosis and haemostasis : JTH (2023)
Abstract
Thrombosis, both venous and arterial, is a leading cause of morbidity and mortality in patients with cancer. Studies on the molecular basis of cancer-associated thrombophilia have a long story starting from the first observation of the presence of tumor cells in circulating microthrombi 2 centuries ago. The profound link between pathways of blood coagulation and tumor biology has been more and more unraveled, and new actors in this complex interaction have been identified. The unfavorable impact of thrombosis in a patient with cancer, on which also hangs a high bleeding risk as compared to the noncancer population, has led during years to the production of large clinical studies to adopt the best prophylaxis and treatment strategies of venous thromboembolism in different medical and surgical settings, now incorporated in dedicated international guidelines. This field, however, still represents an open challenge due to the intrinsic variability of the patient with cancer with his/her personal medical history and cardiovascular risk factors, as well as the type, site and stage of the tumor, and the use of a wide array of new sophisticated anticancer drugs. This review aims to highlight some of the many key observations in the field of cancer and thrombosis, spanning the scope from fundamental tumor biology to advanced clinical trials of new anticoagulants. We hope that some of the examples we have included will inspire readers to explore and discuss these topics, thereby increasing awareness of cancer-related thrombosis in both physicians and patients.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Thrombosis, both venous and arterial, is a leading cause of morbidity and mortality in patients with cancer. Studies on the molecular basis of cancer-associated thrombophilia have a long story starting from the first observation of the presence of tumor cells in circulating microthrombi 2 centuries ago.
Why This Matters for Hirudotherapy
This review examines cancer-associated thrombosis, covering the molecular basis linking tumor biology to blood coagulation, clinical risk factors, prophylaxis and treatment strategies, and challenges posed by patient variability and novel anticancer therapies. It highlights the complex interplay between thrombosis and bleeding risk in cancer patients and notes that international guidelines have incorporated findings from large clinical studies. The review spans fundamental tumor biology to advanced clinical trials of new anticoagulants and calls for increased awareness of cancer-related thrombosis. The abstract does not mention leeches, hirudotherapy, hirudin, or any leech-derived therapy. Its relevance to ASH is absent, as the focus is on conventional and emerging anticoagulant strategies in oncology without any leech connection.
Citation
Cancer-associated thrombosis: enhanced awareness and pathophysiologic complexity.
Falanga et al. · Journal of thrombosis and haemostasis : JTH, 2023
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