VENSKE TROMBOEMBOLIJSKE KOMPLIKACIJE KOD PACIJENATA SA LIMFOMOM
Ključne reči:
limfomi, VTE, tromboprofilaksa, LMWH, DOAK
Sažetak
Limfomi čine heterogenu grupu malignih hematoloških oboljenja koje karakteriše visok rizik za razvoj venskih tromboembolijskih komplikacija (VTE), sa posledičnim značajnim uticajem na morbiditet i mortalitet ovih pacijenata. Rastuću pažnju zaokupljuje i finansijsko opterećenje zdravstvenog sistema prouzrokovano ovom komplikacijom. Kompleksna biologija limfoma, u sadejstvu sa različitim faktorima rizika za razvoj VTE, rezultuje kompleksnom disregulacijom hemostatske ravnoteže u prokoagulantnom smeru. S obzirom na incidenciju razvoja VTE kod pacijenata sa limfomom, stvorila se potreba kako za razvojem alata za pouzdanu procenu rizika za razvoj VTE kod ove grupe pacijenata, tako i za efikasnom profilaksom i lečenjem ove komplikacije. Činjenica da se radi o pacijentima sa malignom bolešću, čiji se klinički tok i lečenje karakteriše širokim spektrom potencijalnih komplikacija, zadatak prevencije i lečenja VTE postaje još kompleksniji. Tokom poslednjih godina ostvaren je veliki napredak u razumevanju patofizioloških mehanizama razvoja trombotičkih komplikacija, a značajan broj kontrolisanih randomizovanih studija omogućio je standardizaciju profilakse i lečenja VTE komplikacija kod pacijenata sa malignitetom. U odnosu na ranije preporuke, pored upotrebe niskomolekularnih heparina (LMWH), primena direktnih oralnih antikoagulantnih lekova (DOAK) postepeno se izjednačava sa LMWH u pogledu profila efikasnosti i bezbednosti u navedenim indikacijama. Ovaj sistematski pregled je fokusiran na najnovija patofiziološka dostignuća, faktore rizika za razvoj VTE, profilaktičke i terapijske preporuke tretiranja VTE kod pacijenata obolelih od limfoma.
Reference
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2. Donnellan E, Khorana AA. Cancer and Venous Thromboembolic Disease: A Review. Oncologist. 2017/02/07. 2017;22(2):199–207.
3. Falanga A, Marchetti M, Russo L. Venous thromboembolism in the hematologic malignancies. Curr Opin Oncol. 2012;24(6):702–10.
4. Swerdlow SH, Campo E, Pileri SA, Harris NL, Stein H, Siebert R, et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood. 2016;127(20):2375–90.
5. Goldschmidt N, Linetsky E, Shalom E, Varon D, Siegal T. High incidence of thromboembolism in patients with central nervous system lymphoma. Cancer. 2003;98(6):1239–42.
6. Lekovic D, Miljic P, Mihaljevic B. Increased risk of venous thromboembolism in patients with primary mediastinal large B-cell lymphoma. Thromb Res. 2010;126(6):477–80.
7. Yokoyama K, Murata M, Ikeda Y, Okamoto S. Incidence and risk factors for developing venous thromboembolism in Japanese with diffuse large b-cell lymphoma. Thromb Res. 2012;130(1):7–11.
8. Caruso V, Di Castelnuovo A, Meschengieser S, Lazzari MA, de Gaetano G, Storti S, et al. Thrombotic complications in adult patients with lymphoma: a meta-analysis of 29 independent cohorts including 18 018 patients and 1149 events. Blood. 2010;115(26):5322–8.
9. Borchmann S, Muller H, Hude I, Fuchs M, Borchmann P, Engert A. Thrombosis as a treatment complication in Hodgkin lymphoma patients: a comprehensive analysis of three prospective randomized German Hodgkin Study Group (GHSG) trials. Ann Oncol Off J Eur Soc Med Oncol. 2019;30(8):1329–34.
10. Zhou X, Teegala S, Huen A, Ji Y, Fayad L, Hagemeister FB, et al. Incidence and risk factors of venous Thromboembolic events in lymphoma. Am J Med. 2010;123(10):935–41.
11. Yıldız A, Albayrak M, Pala Ç, Afacan Öztürk HB, Maral S, Şahin O, et al. The incidence and risk factors of thrombosis and the need for thromboprophylaxis in lymphoma and leukemia patients: A 9-year single-center experience. J Oncol Pharm Pract. 2020;26(2):386–96.
12. Mohren M, Markmann I, Jentsch-Ullrich K, Koenigsmann M, Lutze G, Franke A. Increased risk of thromboembolism in patients with malignant lymphoma: A single-centre analysis. Br J Cancer. 2005;92(8):1349–51.
13. Lyman GH, Khorana AA, Falanga A. Thrombosis and Cancer: Emerging Data for the Practicing Oncologist. Am Soc Clin Oncol Educ B. 2013;(33):e337–45.
14. Sanfilippo KM, Wang TF, Gage BF, Luo S, Riedell P, Carson KR. Incidence of venous thromboembolism in patients with non-Hodgkin lymphoma. Thromb Res. 2016;143:86–90.
15. Kekre N, Connors JM. Venous thromboembolism incidence in hematologic malignancies. Blood Rev. 2019;33:24–32.
16. Dharmavaram G, Cao S, Sundaram S, Ayyapan S, Boughan K, Gallogly M, et al. Aggressive Lymphoma Subtype Is A Risk Factor for Venous Thrombosis. Development of Lymphoma – Specific Venous Thrombosis Prediction Models. Am J Hematol. 2020;
17. Metharom P, Falasca M, Berndt MC. The history of armand trousseau and cancer-associated thrombosis. Cancers (Basel). 2019;11(2):2–5.
18. Karimi M, Cohan N. Cancer-associated thrombosis. Open Cardiovasc Med J. 2010;4:78–82.
19. Falanga A, Russo L, Milesi V, Vignoli A. Mechanisms and risk factors of thrombosis in cancer. Crit Rev Oncol Hematol. 2017;118(August):79–83.
20. Khorana AA. Cancer and thrombosis: Implications of published guidelines for clinical practice. Ann Oncol. 2009;20(10):1619–30.
21. Elyamany G, Alzahrani AM, Bukhary E. Cancer-associated thrombosis: An overview. Clin Med Insights Oncol. 2014;8:129–37.
22. Falanga A, Marchetti M, Vignoli A. Coagulation and cancer: biological and clinical aspects. J Thromb Haemost. 2013;11(2):223–33.
23. Mukai M, Oka T. Mechanism and management of cancer-associated thrombosis. J Cardiol. 2018;72(2):89–93.
24. Théry C, Witwer KW, Aikawa E, Alcaraz MJ, Anderson JD, Andriantsitohaina R, et al. Minimal information for studies of extracellular vesicles 2018 (MISEV2018): a position statement of the International Society for Extracellular Vesicles and update of the MISEV2014 guidelines. J Extracell Vesicles. 2018;7(1):1535750.
25. Kim AS, Khorana AA, McCrae KR. Mechanisms and biomarkers of cancer-associated thrombosis. Transl Res. 2020;225:33–53.
26. Fuentes HE, Tafur AJ, Caprini JA. Cancer-associated thrombosis. Disease-a-Month. 2016;62(5):121–58.
27. Hisada Y, Mackman N. Cancer-associated pathways and biomarkers of venous thrombosis. Blood. 2017;130(13):1499–506.
28. Al-Samkari H, Song AB, Connors JM. Cancer-associated thrombosis: Where do we stand? Adv CELL GENE Ther. 2020;3(1):e73.
29. Mitrugno A, Tassi Yunga S, Sylman JL, Zilberman-Rudenko J, Shirai T, Hebert JF, et al. The role of coagulation and platelets in colon cancer-associated thrombosis. Am J Physiol Cell Physiol. 2019;316(2):C264–73.
30. Razak NBA, Jones G, Bhandari M, Berndt MC, Metharom P. Cancer-associated thrombosis: An overview of mechanisms, risk factors, and treatment. Cancers (Basel). 2018;10(10):1–21.
31. Charlotte T, Yohei H, Staffan L, Nigel M, Håkan W. Neutrophil Extracellular Traps. Arterioscler Thromb Vasc Biol. 2019;39(9):1724–38.
32. Aksu K, Donmez A, Keser G. Inflammation-induced thrombosis: mechanisms, disease associations and management. Curr Pharm Des. 2012;18(11):1478–93.
33. Coussens LM, Werb Z. Inflammation and cancer. Nature. 2002;420(6917):860–7.
34. Diakos CI, Charles KA, McMillan DC, Clarke SJ. Cancer-related inflammation and treatment effectiveness. Lancet Oncol. 2014;15(11):e493-503.
35. Alfaro C, Teijeira A, Oñate C, Pérez G, Sanmamed MF, Andueza MP, et al. Tumor-Produced Interleukin-8 Attracts Human Myeloid-Derived Suppressor Cells and Elicits Extrusion of Neutrophil Extracellular Traps (NETs). Clin cancer Res an Off J Am Assoc Cancer Res. 2016;22(15):3924–36.
36. Antic D, Milic N, Bontekoe E, Hoppensteadt D, Djurasinovic V, Vukovic V, et al. Biomarkers of Hemostatic Dysregulation and Inflammation in Lymphoma: Potential Relevance to Thrombogenesis. Blood. 2019;134(Supplement_1):4945.
37. Khorana AA, Connolly GC. Assessing risk of venous thromboembolism in the patient with cancer. J Clin Oncol. 2009;27(29):4839–47.
38. Antic D, Jelicic J, Vukovic V, Nikolovski S, Mihaljevic B. Venous thromboembolic events in lymphoma patients: Actual relationships between epidemiology, mechanisms, clinical profile and treatment. Blood Rev. 2018;32(2):144–58.
39. Connolly GC, Khorana AA. Emerging risk stratification approaches to cancer-associated thrombosis: risk factors, biomarkers and a risk score. Thromb Res. 2010;125 Suppl:S1–7.
40. Heit JA, Spencer FA, White RH. The epidemiology of venous thromboembolism. J Thromb Thrombolysis. 2016/01/16. 2016;41(1):3–14.
41. Shapiro SS. The lupus anticoagulant/antiphospholipid syndrome. Annu Rev Med. 1996;47:533–53.
42. Marlar RA, Husain S. The enigmas of the lupus anticoagulant: mechanisms, diagnosis, and management. Curr Rheumatol Rep. 2008;10(1):74–80.
43. Wahl DG, Guillemin F, De Maistre E, Perret-Guillaume C, Lecompte T, Thibaut G. Meta-analysis of the risk of venous thrombosis in individuals with antiphospholipid antibodies without underlying autoimmune disease or previous thrombosis. Lupus. 1998;7(1):15–22.
44. Lechner K, Simonitsch I, Haselböck J, Jäger U, Pabinger I. Acquired immune-mediated thrombophilia in lymphoproliferative disorders. Leuk Lymphoma. 2011;52(10):1836–43.
45. Gebhart J, Lechner K, Skrabs C, Sliwa T, Müldür E, Ludwig H, et al. Lupus anticoagulant and thrombosis in splenic marginal zone lymphoma. Thromb Res. 2014;134(5):980–4.
46. Moons KGM, Kengne AP, Grobbee DE, Royston P, Vergouwe Y, Altman DG, et al. Risk prediction models: II. External validation, model updating, and impact assessment. Heart. 2012;98(9):691–8.
47. Khorana AA, Kuderer NM, Culakova E, Lyman GH, Francis CW. Development and validation of a predictive model for chemotherapy-associated thrombosis. Blood. 2008;111(10):4902–7.
48. Mulder FI, Candeloro M, Kamphuisen PW, Di Nisio M, Bossuyt PM, Guman N, et al. The Khorana score for prediction of venous thromboembolism in cancer patients: a systematic review and meta-analysis. Haematologica. 2019;104(6):1277–87.
49. Rupa-Matysek J, Gil L, Kazmierczak M, Baranska M, Komarnicki M. Prediction of venous thromboembolism in newly diagnosed patients treated for lymphoid malignancies: validation of the Khorana Risk Score. Med Oncol. 2017;35(1):5.
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