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Paraneoplastische Gerinnungsstörungen

Cancer-related coagulation disorders

  • CME Zertifizierte Fortbildung
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Der Onkologe Aims and scope

Zusammenfassung

Hintergrund

Paraneoplastische Gerinnungsstörungen sind häufige Komplikationen bei Patienten mit onkologischen Grunderkrankungen.

Methode

Auf der Grundlage pathogenetischer Einblicke in das Zusammenwirken von Tumorzelle und Hämostase soll der Beitrag eine Übersicht über paraneoplastische thromboembolische und hämorrhagische Komplikationen und deren Therapie geben. Besonderes Augenmerk wird dabei auf die Bedeutung von im klinischen Alltag verfügbaren Laborparametern für die Diagnostik dieser Gerinnungsstörungen gelegt.

Ergebnisse

Die Kenntnis über das assoziative Auftreten bestimmter thromboembolischer bzw. hämorrhagischer Krankheitsbilder mit malignen Grunderkrankungen kann deren frühe zielgerichtete Diagnostik und Therapie ermöglichen. Letztere sind unabdingbare Voraussetzung dafür, die mit den paraneoplastischen Gerinnungsstörungen einhergehende erhöhte Morbidität und Mortalität für die betroffenen Patienten zu senken.

Schlussfolgerung

Von besonderer Bedeutung ist die Implementierung vorhandener Leitlinien in die klinische Versorgung der Malignompatienten, beispielsweise zur Prophylaxe und Therapie der venösen Thromboembolie.

Abstract

Background

Cancer-related coagulation disorders are common complications of patients with solid or hematological neoplasms.

Methods

This article gives an overview of paraneoplastic thromboembolic and hemorrhagic complications and therapy of patients with solid or hematological neoplasms under consideration of pathogenetic insights into the interaction of tumor cells and hemostasis. Special attention will be paid to routine clinical laboratory coagulation parameters in terms of their importance for the manifestation of a clinical event (thrombosis or hemorrhage).

Results/Conclusion

Knowledge of thromboembolic or hemorrhagic syndromes in underlying malignancies allows early diagnosis and targeted therapy and helps to reduce morbidity and mortality.

Conclusion

Of particular importance is the implementation of existing guidelines in the clinical treatment of patients with malignancies, e.g. prophylaxis and treatment of venous thromboembolism.

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Literatur

  1. Trousseau A (1865) Phlegmasia alba dolens. Clinique medicale de l’Hotel-Dieu de Paris, Bd 3. Balliere, Paris, S 654–712

  2. Khorana AA, Kuderer NM, Culakova E et al (2008) Development and validation of a predictive model for chemotherapy-associated thrombosis. Blood 111:4902–4907

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  3. Falanga A, Marchetti M, Vignoli A (2013) Coagulation and cancer: biological and clinical aspects. J Thromb Haemost 11:223–233

    Article  CAS  PubMed  Google Scholar 

  4. Oberic L, Buffet M, Schwarzunger M et al (2009) Cancer awareness in atypical thrombotic microangiopathies. Oncologist 14:769–779

    Article  PubMed  Google Scholar 

  5. Reikvam H, Tiu RV (2012) Venous thromboembolism in patients with essential thrombocythemia and polycythemia vera. Leukemia 26:563–571

    Article  CAS  PubMed  Google Scholar 

  6. Garnier D, Magnus N, D’Asti E et al (2012) Genetic pathways linking hemostasis and cancer. Thromb Res [Suppl 1] 129:22–29

    Google Scholar 

  7. Lyman GH, Khorana AA, Kuderer NM et al (2013) Venous thromboembolism prophylaxis and treatment in patients with cancer: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol 31:2189–2204

    Article  CAS  PubMed  Google Scholar 

  8. Khorana AA (2013) Cancer-associated thrombosis: updates and controversies. J Thromb Haemost 11:1760–1765

    Article  PubMed  Google Scholar 

  9. Barbui T, Finazzi G, Falanga A (2013) Myeloproliferative neoplasms and thrombosis. Blood 122:2176–2184

    Article  CAS  PubMed  Google Scholar 

  10. Smalberg JH, Arends LR, Valla DC et al (2013) Myeloproliferative neoplasms in Budd-Chiari syndrome and portal vein thrombosis: a meta-analysis. Blood 120:4921–4928

    Article  Google Scholar 

  11. Panova-Noeva M, Marchetti M, Buoro S et al (2011) JAK2V617F mutation and hydroxyurea treatment as determinants of immature platelet parameters in essential thrombocythemia and polycythemia vera patients. Blood 118:2599–2601

    Article  CAS  PubMed  Google Scholar 

  12. Tefferi A (2013) Polycythemia vera and essential thrombocythemia: 2013 update on diagnosis, risk-stratification, and management. Am J Hematol 88:507–516

    Article  CAS  PubMed  Google Scholar 

  13. Westbrook RH, Lea NC, Mohamedali AM et al (2012) Prevalence and clinical outcomes of the 46/1 haplotype, Janus kinase 2 mutations, and ten-eleven translocation 2 mutations in Budd-Chiari syndrome and their impact on thrombotic complications post liver transplantation. Liver Transpl 18:819–827

    Article  PubMed  Google Scholar 

  14. Lechner K, Obermeier HL (2012) Cancer-related microangiopathic hemolytic anemia: clinical and laboratory features in 168 reported cases. Medicine (Baltimore) 91:195–205

    Google Scholar 

  15. Schultheis B, Adamietz IA, Strumberg D (2010) Oncologic emergencies II. Metabolic and coagulation disorders. Onkologe 16:809–816

    Article  Google Scholar 

  16. Shetty S, Kasatkar P, Ghosh K (2011) Pathophysiology of acquired von Willebrand diasease: a concise review. Eur J Haematol 87:99–106

    Article  CAS  PubMed  Google Scholar 

  17. Tiede A, Rand JH, Budde U et al (2011) How I treat the acquired von Willebrand syndrome. Blood 117:6777–6785

    Article  CAS  PubMed  Google Scholar 

  18. Sborov DW, Rodgers GM (2013) How I manage patients with acquired haemophilia A. Br J Haematol 161:157–165

    Article  CAS  PubMed  Google Scholar 

  19. Reeves BN, Key NS (2012) Acquired hemophilia in malignancy. Thromb Res [Suppl 1] 129:66–68

    Google Scholar 

  20. Franchini M, Di Minno MN, Coppola A (2010) Disseminated intravascular coagulation in hematologic malignancies. Semin Thromb Hemost 36:388–403

    Article  CAS  PubMed  Google Scholar 

  21. Avvisati G (2013) Coagulopathy in APL: a step forward? Blood 120:4–6

    Article  Google Scholar 

  22. Levi M, Toh CH, Thachil J et al (2009) British Committee for Standards in Haematology. Guidelines for the diagnosis and management of disseminated intravascular coagulation. Br J Haematol 145:24–33

    Article  CAS  PubMed  Google Scholar 

  23. Wada H, Thachil J, Di Nisio M et al (2013) Guidance for diagnosis and treatment of DIC from harmonization of the recommendations from three guidelines. J Thromb Haemost 11:761–767

    Article  CAS  Google Scholar 

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Einhaltung ethischer Richtlinien

Interessenkonflikt. K. Schilling und A. Hochhaus geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag enthält keine Studien an Menschen und Tieren.

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Correspondence to K. Schilling.

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Schilling, K., Hochhaus, A. Paraneoplastische Gerinnungsstörungen. Onkologe 20, 497–508 (2014). https://doi.org/10.1007/s00761-013-2644-4

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  • DOI: https://doi.org/10.1007/s00761-013-2644-4

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