TABLE 5. Summary of American Society of Clinical Oncology 2007 Guidelines on Venous Thromboembolism (VTE) Prophylaxis and Treatment in Patients with Cancer.13.
| Patient group | Recommended | Not recommended |
|---|---|---|
| Hospitalized patients with cancer | VTE prophylaxis with anticoagulants (LMWH, UFH, or fondaparinux) | If presence of bleeding or other contraindications to anticoagulation |
| Ambulatory patients with cancer receiving chemotherapy | LMWH or adjusted-dose warfarin for patients with multiple myeloma receiving thalidomide or lenalidomide plus chemotherapy or dexamethasone | Otherwise, no routine VTE prophylaxis |
| Patients with cancer undergoing surgery | Prophylaxis with low-dose UFH, LMWH, or fondaparinux for at least 7-10 days Combined prophylaxis with mechanical methods for patients at very high risk |
If presence of bleeding or other contraindications to anticoagulation Consider mechanical methods alone for those with contraindications to pharmacological methods |
| Patients with cancer with established VTE | LMWH for the initial 5-10 days LMWH for at least 6 months or vitamin K antagonists (target INR 2-3) when LMWH unavailable Consider continued anticoagulation beyond 6 months in those with active cancer |
|
| Patients with cancer without VTE, to improve survival | Prophylaxis not recommended |
INR, international normalized ratio; LMWH, low-molecular-weight heparin; UFH, unfractionated heparin.