Medical Oncology

Hemostasis/Thrombosis   

Questions discussed in this category



While follow up ultrasound is not usually recommended in provoked DVT, it often is done either for other reasons or by other physicians. Would this in...

What is the work up and what is the duration of anticoagulation if used?

Specifically, asymptomatic subsegmental PE diagnosed within a month from planned bilateral mastectomy for breast cancer. 

Would you consider low dose indefinite anticoagulation in any scenario? Any difference in approach between hematological malignancy and solid tum...

What is your preferred agent (DOAC, warfarin, enoxaparin), and is periprocedural bridging necessary?

- Dialysis catheter used for hemodialysis- RIJ thrombus in dialysis catheter was incidentally found- Patient asymptomatic with no prior history of VTE...

In the setting of no personal or family history and no other risk factors for thrombosis, is systemic anticoagulation warranted if local treatments (e...

In the absence of a VTE would you consider prophylaxis after a surgical procedure? Often non-hematologists order this testing but we are consulted for...

How does cirrhosis and/or underlying thrombophilia affect your decision?

Conversion tables suggest starting the new drug with the next dose but do not seem to answer this question (i.e. if switching from rivaroxaban 20 mg d...

Would you offer indefinite anticoagulation if the event is unprovoked and the patient has low bleeding risk? 

Please also discuss the type and duration of anticoagulation.

Provoked or unprovoked VTE: Do you use D-Dimer (or even repeat imaging to reassess residual clot) in any capacity to guide anticoagulation duration? E...

Have you used anticoagulants other than coumadin? Or is that the only appropriate agent given monitoring is based on PT/INR?

Do you feel comfortable with BTK inhibitors in these patients? In ELEVATE-RR patients on a/c were excluded, and rate of atrial fibrillation in the ac...

While there are many factors involving:- type (DVT vs PE, unprovoked vs provoked) and severity of venous thromboembolism (VTE) size- duration of antic...

While this is a known risk factor for venous [Meijers et al NEJM 2000] and potentially arterial [Yang et al, Am J Clin Pathol 2006] thrombosis, it is ...

Do you recommend therapeutic phlebotomy to a certain Hct goal? Any strong evidence for thromboembolic risk related to erythrocytosis or if this is mit...

Given recent data in Blood (Moik et al, 2021), and the potentially overlapping risks with other clinical factors associated with NSCLC. Will you alte...

Is there any difference between anticoagulants in this clinical context (e.g. anti-Xa inhibitors vs warfarin vs LMWH)?

Does having a concurrent consumptive process e.g. DIC change your management? 

Assuming the patient is a candidate for all anticoagulation options (no mechanical valve, antiphospholipid syndrome, patient-specific contraindication...

While thrombophilia testing is not routinely recommended prior to starting OCPs, how about after the development of a VTE?

While the CKD population is at high thrombotic and bleeding risk, would you consider anticoagulating a patient prophylactically if they had a history ...

Ref: EINSTEIN-CHOICE and AMPLIFY-EXT Would you approach this differently in patients with inherited thrombophilias?

For example, a patient on cytoreductive therapy and aspirin BID, but suffers an arterial event, or a patient who is already on therapeutic anticoagula...

In a patient with a medical or personal indication to induce oligomenorrhea/amenorrhea, how would you manage OCP therapy if a patient develops a VTE d...

If there are a low-risk patients who can be monitored, how would you do so? If unprovoked, would you consider stopping anticoagulation?

Is there a preferred strategy of transfusional support versus reduced-dose anticoagulation during the duration of thrombocytopenia?


Papers discussed in this category


Thrombosis research, 2019-01

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2018-07-10

The New England journal of medicine, 2018-02-15

Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis, 2016-04

Blood, 2018 Jul 12

Ann. Intern. Med., 2019 Oct 15

Blood Transfus, 2018 Oct 24

J Thromb Haemost, 2018 May 08

AJR Am J Roentgenol,

J Vasc Interv Radiol, 2020 Sep 09

Blood, 2015 Dec 22

Contraception, 2016 May 03

Blood Cancer J, 2018 Feb 09

Blood, 2017 May 08

Blood, 2013-12-05

Blood Adv,

Blood,

Thrombosis, 2013

Thrombosis journal, 2023 Oct 26

PLoS One, 2021 Apr 08

The New England journal of medicine, 2016-11-10

The New England journal of medicine, 2018-05-31

The New England journal of medicine, 2018-06-14

Lancet (London, England), 2019-05-04

Lung cancer (Amsterdam, Netherlands), 2012-12

N Engl J Med,

Blood,

Cancers (Basel), 2019 Dec 25

N Engl J Med, 2021 Apr 14

Blood, 2016-07-14

Blood, 2016 Sep 26

J Thromb Thrombolysis,

J Am Heart Assoc, 2020 Nov 23

Am J Hematol,

Blood advances, 2018-11-27

Blood advances, 2018-11-27

Blood Adv, 2017 Jun 22

Haematologica, 2019 Jan 03