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Treatment Algorithm in Cancer-Associated Thrombosis: Canadian Expert Consensus

Department of Medicine, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON K1H 8L6, Canada
Department of Medicine, Centre hospitalier de l’Université de Montréal, Montreal, QC, Canada
Department of Medicine, McMaster University, Hamilton, ON, Canada
Department of Oncology, Sir Mortimer B. Davis Jewish General Hospital, McGill University, Montreal, QC, Canada
Department of Hematology, Royal University Hospital, Saskatoon, SK, Canada
Department of Medicine, qeii Health Sciences Centre, Dalhousie University, Halifax, NS, Canada
Department of Medicine, Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Montreal, QC, Canada
Department of Medicine, University of Alberta, Edmonton, AB, Canada
Department of Medicine, University of British Columbia, BC Cancer, Vancouver, BC, Canada
Author to whom correspondence should be addressed.
Curr. Oncol. 2018, 25(5), 329-337;
Submission received: 9 July 2018 / Revised: 12 August 2018 / Accepted: 2 September 2018 / Published: 1 October 2018


Management of anticoagulant therapy for the treatment of venous thromboembolism (VTE) in cancer patients is complex because of an increased risk of recurrent VTE and major bleeding complications in those patients relative to the general population. Subgroups of patients with cancer also show variation in their risk for recurrent VTE and adverse bleeding events. Accordingly, a committee of 10 Canadian clinical experts developed the consensus risk- stratification treatment algorithm presented here to provide guidance on tailoring anticoagulant treatment choices for the acute and extended treatment of symptomatic and incidental VTE, to prevent recurrent VTE, and to minimize the bleeding risk in patients with cancer. During a 1-day live meeting, a systematic review of the literature was performed, and a draft treatment algorithm was developed. The treatment algorithm was refined through the use of a Web-based platform and a series of online teleconferences. Clinicians using this treatment algorithm should consider the bleeding risk, the type of cancer, and the potential for drug–drug interactions in addition to informed patient preference in determining the most appropriate treatment for patients with cancer-associated thrombosis. Anticoagulant therapy should be regularly reassessed as the patient’s cancer status and management change over time.
Keywords: venous thromboembolism; venous thrombosis; hemorrhage; heparin; low-molecular-weight venous thromboembolism; venous thrombosis; hemorrhage; heparin; low-molecular-weight

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MDPI and ACS Style

Carrier, M.; Blais, N.; Crowther, M.; Kavan, P.; Le Gal, G.; Moodley, O.; Shivakumar, S.; Tagalakis, V.; Wu, C.; Lee, A.Y.Y. Treatment Algorithm in Cancer-Associated Thrombosis: Canadian Expert Consensus. Curr. Oncol. 2018, 25, 329-337.

AMA Style

Carrier M, Blais N, Crowther M, Kavan P, Le Gal G, Moodley O, Shivakumar S, Tagalakis V, Wu C, Lee AYY. Treatment Algorithm in Cancer-Associated Thrombosis: Canadian Expert Consensus. Current Oncology. 2018; 25(5):329-337.

Chicago/Turabian Style

Carrier, M., N. Blais, M. Crowther, P. Kavan, G. Le Gal, O. Moodley, S. Shivakumar, V. Tagalakis, C. Wu, and A.Y.Y. Lee. 2018. "Treatment Algorithm in Cancer-Associated Thrombosis: Canadian Expert Consensus" Current Oncology 25, no. 5: 329-337.

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