Table 2.
Thromboembolic events in patients with testicular germ cell tumors who underwent cisplatin-based chemotherapy at our Institution (n = 19)
|
Type/pathologic stage of testicular tumor
|
RPLN ≥ 3.0 cm before chemotherapy
|
Type/number of cycles of chemotherapy
|
PE/DVT
|
Timing of PE/DVT in relation to chemotherapy
|
Anticoagulant
|
Hospitalization
|
| Seminoma IIB | Yes | BEP (2 cycles), EP (1 cycles) | DVT | Same day immediately prior to Cycle 1 | Fondaparinux sodium | Yes |
| Seminoma IIA | No | EP (3 cycles) | DVT1 | During (Cycle 1) | Heparin → apixaban | Yes |
| Seminoma IIIB | No | EP (4 cycles) | PE + DVT2 | 3 yr after initial chemotherapy, recurrent disease | Enoxaparin sodium | Yes |
| Non-seminoma IIB | Yes | BEP (2 cycles) | DVT2 | During (Cycle 2) | Warfarin →enoxaparin sodium | Yes |
| Non-seminoma IIB | No | BEP (3 cycles) | PE | During (Cycle 2) | Heparin → enoxaparin sodium → rivaroxaban → apixaban | Yes |
| Non-seminoma IIC | Yes | EP (4 cycles) | PE + DVT | 1 wk before Cycle 1 | Heparin (lovenox) → warfarin | Yes |
| Non-seminoma IIA | No | BEP (3 cycles) | DVT2 | During (Cycle 2) | Fondaparinux sodium | No |
| Non-seminoma IIB | Yes | BEP (3 cycles) | PE1 | During (Cycle 3) | Fondaparinux sodium → warfarin | No |
| Seminoma IIA | No | BEP (3 cycles) | DVT2 | During (Cycle 3) | None | No |
| Seminoma III | No | BEP (3 cycles) | PE | During (Cycle 3) | Enoxaparin sodium | No |
| Non-seminoma IIIC | Yes | BEP (4 cycles) | PE | During (Cycle 4) | Enoxaparin sodium | No |
| Non-seminoma IIIC | Yes | BEP (4 cycles) | DVT | During (Cycle 3) | Enoxaparin sodium | No |
| Non-seminoma IIA | No | BEP (3 cycles) | PE | During (Cycle 3) | Heparin → rivaroxaban | Yes |
| Non-seminoma IIA | No | BEP (2 cycles) | PE | During (Cycle 2) | Enoxaparin sodium | No |
| Seminoma IIC | Yes | BEP (3 cycles) | PE | 1 mo after chemotherapy ended | Heparin → enoxaparin sodium | Yes |
| Seminoma IIA | No | BEP (3 cycles) | PE + DVT | During (Cycle 2) | Heparin → enoxaparin sodium | Yes |
| Non-seminoma IIB | No | BEP (3 cycles) | DVT | 1 d prior to Cycle 1 | Heparin → fondaparinux sodium | Yes |
| Non-seminoma IIIA | No | BEP (3 cycles) | PE | 2 wk after chemotherapy ended | Warfarin + enoxaparin sodium | No |
| Seminoma IIC | Yes | EP (4 cycles) | DVT2 | During (Cycle 2) | Enoxaparin sodium → fondaparinux | Yes |
1
Infusaport.
2
Peripherally inserted central catheter line. PE: Pulmonary embolism; BEP: Bleomycin, etoposide, and cisplatin; DVT: Deep vein thrombosis; EP: Etoposide and cisplatin.