THROMBOSES IN ONCOLOGY. PART 1

Abstract

Oncological disease increases the risk of developing arterial thrombosis mainly in the coronary and cerebrovascular beds. Among the pathogenetic mechanisms of this complication the authors consider the direct toxic effect on the endothelium produced by some groups of chemotherapeutic drugs, the procoagulant effect of the tumor, inhibition of endogenous fibrinolysis and increased platelet aggregation. Activation of the inflammation caused by increased synthesis of inflammatory mediators and adhesion molecules is also relevant, as well as vasospastic and direct damaging effects of radiation therapy on the endothelium. Patients with ACS against the background of the ongoing oncological process, on the one hand, are at a high risk for thrombotic complications, while, on the other hand, they have limitations for antiplatelet therapy due to thrombocytopenia. Therefore, the decision on the possibility, composition and duration of antiplatelet therapy in such patients should be taken by cardiologists jointly with oncologists and chemotherapists. The article has two parts. The first examines the specific hemo-stasis in cancer, some mechanisms of the pathogenesis of arterial and venous thrombosis, as well as treatment of cancer patients who developed arterial thrombosis. The second part provides a review of the literature on the prevention and treatment of venous thromboembolic complications associated with cancer.

Keywords

• arterial thrombosis
• oncological patients
• prevention
• treatment