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Treatment of venous thromboembolism in cancer patients with dalteparin for up to 12 months: the DALTECAN Study.

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  • معلومة اضافية
    • Author-Supplied Keywords:
      cancer
      dalteparin
      deep vein thrombosis
      low ‐ molecular ‐ weight heparin
      low-molecular-weight heparin
      pulmonary embolism
      venous thromboembolism
    • Abstract:
      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. [ABSTRACT FROM AUTHOR]
    • Abstract:
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    • Author Affiliations:
      1University of Rochester Medical Center, Rochester NY, USA
      2Georgetown University Hospital, Washington DC, USA
      3Brigham and Women's Hospital, Boston MA, USA
      4London Health Sciences Centre, London Ontario, Canada
      5Hospital Universitari Germans Trias i Pujol, Carretera de Canyet Barcelona, Spain
      6Leiden University Medical Center, Leiden the Netherlands
      7University Hospital, Uppsala Sweden
      8Hamilton Health Sciences, McMaster University, Hamilton ON, Canada
      9Duke University Medical Center, Durham NC, USA
      10Medical University of Vienna, Wien Austria
      11Barts and The London Queen Mary's School of Medicine and Dentistry, London UK
    • ISSN:
      1538-7933
    • Accession Number:
      10.1111/jth.12923
    • Accession Number:
      102991052
  • Citations
    • ABNT:
      FRANCIS, C. W. et al. Treatment of venous thromboembolism in cancer patients with dalteparin for up to 12 months: the DALTECAN Study. Journal of Thrombosis & Haemostasis, [s. l.], v. 13, n. 6, p. 1028–1035, 2015. DOI 10.1111/jth.12923. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=asn&AN=102991052&custid=s8280428. Acesso em: 4 ago. 2020.
    • AMA:
      Francis CW, Kessler CM, Goldhaber SZ, et al. Treatment of venous thromboembolism in cancer patients with dalteparin for up to 12 months: the DALTECAN Study. Journal of Thrombosis & Haemostasis. 2015;13(6):1028-1035. doi:10.1111/jth.12923.
    • AMA11:
      Francis CW, Kessler CM, Goldhaber SZ, et al. Treatment of venous thromboembolism in cancer patients with dalteparin for up to 12 months: the DALTECAN Study. Journal of Thrombosis & Haemostasis. 2015;13(6):1028-1035. doi:10.1111/jth.12923
    • APA:
      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. (2015). Treatment of venous thromboembolism in cancer patients with dalteparin for up to 12 months: the DALTECAN Study. Journal of Thrombosis & Haemostasis, 13(6), 1028–1035. https://doi.org/10.1111/jth.12923
    • Chicago/Turabian: Author-Date:
      Francis, C. W., C. M. Kessler, S. Z. Goldhaber, M. J. Kovacs, M. Monreal, M. V. Huisman, D. Bergqvist, et al. 2015. “Treatment of Venous Thromboembolism in Cancer Patients with Dalteparin for up to 12 Months: The DALTECAN Study.” Journal of Thrombosis & Haemostasis 13 (6): 1028–35. doi:10.1111/jth.12923.
    • Harvard:
      Francis, C. W. et al. (2015) ‘Treatment of venous thromboembolism in cancer patients with dalteparin for up to 12 months: the DALTECAN Study’, Journal of Thrombosis & Haemostasis, 13(6), pp. 1028–1035. doi: 10.1111/jth.12923.
    • Harvard: Australian:
      Francis, CW, Kessler, CM, Goldhaber, SZ, Kovacs, MJ, Monreal, M, Huisman, MV, Bergqvist, D, Turpie, AG, Ortel, TL, Spyropoulos, AC, Pabinger, I & Kakkar, AK 2015, ‘Treatment of venous thromboembolism in cancer patients with dalteparin for up to 12 months: the DALTECAN Study’, Journal of Thrombosis & Haemostasis, vol. 13, no. 6, pp. 1028–1035, viewed 4 August 2020, .
    • MLA:
      Francis, C. W., et al. “Treatment of Venous Thromboembolism in Cancer Patients with Dalteparin for up to 12 Months: The DALTECAN Study.” Journal of Thrombosis & Haemostasis, vol. 13, no. 6, June 2015, pp. 1028–1035. EBSCOhost, doi:10.1111/jth.12923.
    • Chicago/Turabian: Humanities:
      Francis, C. W., C. M. Kessler, S. Z. Goldhaber, M. J. Kovacs, M. Monreal, M. V. Huisman, D. Bergqvist, et al. “Treatment of Venous Thromboembolism in Cancer Patients with Dalteparin for up to 12 Months: The DALTECAN Study.” Journal of Thrombosis & Haemostasis 13, no. 6 (June 2015): 1028–35. doi:10.1111/jth.12923.
    • Vancouver/ICMJE:
      Francis CW, Kessler CM, Goldhaber SZ, Kovacs MJ, Monreal M, Huisman MV, et al. Treatment of venous thromboembolism in cancer patients with dalteparin for up to 12 months: the DALTECAN Study. Journal of Thrombosis & Haemostasis [Internet]. 2015 Jun [cited 2020 Aug 4];13(6):1028–35. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=asn&AN=102991052&custid=s8280428