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MASCC Hemostasis Study Group

Leadership

Chair: Carmen Escalante, MD (cescalan@mdanderson.org) - USA
Vice-Chair: Thomas Butler, MD (tbutler@health.southalabama.edu) - USA
Vice-Chair: Carme Font, MD (cfont@clinic.ub.es) - Spain

Study Group Minutes
2016 Minutes  - Annual Meeting - Adelaide, Australia

Mission and Goals

The mission of the Hemostasis Study Group is to provide guidance and guidelines to healthcare providers regarding bleeding and clotting complications in cancer patients from diagnosis to the end of life. The goals of the group are (1) an increased awareness of abnormalities in the coagulation system at the time of cancer diagnosis, through treatment, and at the end of life, and (2) an increased availability of evidence-based treatment to patients with bleeding or clotting complications during treatment and at the end of life. To these ends, the Group has set the following objectives:

  • To keep up to date with current guidelines regarding treating cancer patients with bleeding and clotting problems related to their disease;
  • To evaluate current guidelines for their merit and deficiencies in providing adequate treatment to cancer patients with coagulation problems;
  • To focus on anticoagulation treatment and quality of life in cancer patients in both hospital and hospice settings.

Research Highlights

The Clinical Course of Venous Thromboembolism May Differ With Cancer Site
Carme Font is one of a large group of investigators who have collaborated on a study of differences in the clinical course of venous thromboembolism (VTE) in relation to specific cancer sites. The study included data from almost 4000 adult patients with active cancer. Significant differences in the clinical profile of VTE-related outcomes were associated with tumor location. The findings suggest that individualized anticoagulation strategies for cancer-related VTE could improve outcomes and quality of life, while reducing treatment costs. >> Read more.

Incidental Venous Thromboembolism in Cancer Patients on Routine CT Scans
In a prospective cohort study, Carmen Escalante et al. investigated the prevalence of incidental venous thromboemtolism (VTE) in almost 1100 adult cancer patients on routine staging CT scans of the chest, abdomen, or pelvis. The research team also documented symptoms associated with incidental VTEs and determined the incidence of VTE recurrence in these patients after 3 and 6 months. >> Read more.

Romiplostim for the Management of Chemotherapy-Induced Thrombocytopenia
Chemotherapy-induced thrombocytopenia (CIT) can interfere with the optimal course of chemotherapy by necessitating schedule delays and dosage reductions. Some patients experience more severe or persistent thrombocytopenia than others, and their responses are neither well understood nor predictable. Both the prevention and management of CIT are critical in order for patients to benefit fully from chemotherapy. Recently, Dr. Rekha Parameswaran and colleagues reported on the successful use of weekly romiplostim for reducing CIT. Their review included both response to romiplostim therapy and toxicity assessment.  >> Read more

Outpatient Management of Pulmonary Embolism in Cancer
Dr. Carme Font and colleagues in Spain conducted a prospective cohort study to determine the feasibility of outpatient treatment for patients with cancer and sudden, symptomatic vs. incidental PE. They assessed thromboembolism recurrence, major bleeding, and all-cause mortality. The authors also compared the performance of four different prognostic scales in predicting mortality and identifying patients who might be treated at home. The results suggest that a large proportion of patients with cancer and PE can be safely treated as outpatients, particularly those with incidental PE. >> Read more

2017 Workshop

2017 Annual Meeting Workshop, June 22, Washington, DC
Update on Venous Thromboembolism: Approach and Challenges
This workshop will bring together a multinational group of experts to review current evidence and needed knowledge in the area of cancer-associated venous thromboembolism (VTE). It will include discussions of the clinical challenges as well as promote the education of patients, providers, and family members. Highlights include VTE prevention in ambulatory cancer patients, management of long-term treatment, and new oral anticoagulants. The workshop will focus on best practices, as illustrated by case studies, and will include discussion and illustration of various approaches to educating and engaging patients in the treatment process. The workshop will also include a patient presenter, who will speak to the group about the challenges of VTE and quality of life. 

This workshop will be offered jointly by the following MASCC Study Groups: Education; Hemostasis.
Workshop Chairs: Carme Font, Carmen Escalante, Tom Butler, Paz Fernández-Ortega

Recent Member Publications

FOTROCAN Delphi consensus statement regarding the prevention and treatment of cancer-associated thrombosis in areas of uncertainty and low quality of evidence. Jimenez-Fonseca P, Carmona-Bayonas A, Calderon C, Fontcuberta Boj J, Font C, Lecumberri R et al. Clin Transl Oncol. 2017 Feb 27. [Epub ahead of print]

Analysis of clinical factors affecting the rates of fatal pulmonary embolism and bleeding in cancer patients with venous thromboembolism. Trujillo-Santos J, Martos FM, Font C, Farge-Bancel D, Rosa V, Lorenzo A et al. Heliyon. 2017 Jan 16;3(1):e00229. Free PMC Article

Prospective cohort study of cancer patients diagnosed with incidental venous thromboembolism on routine computed tomography scans. Escalante CP, Gladish GW, Qiao W, Zalpour A, Assylbekova B, Gao S et al. Support Care Cancer. 2017 Jan 9. [Epub ahead of print]

Prognostic value of computed tomography pulmonary angiography indices in patients with cancer-related pulmonary embolism: Data from a multicenter cohort study. Plasencia-Martínez JM, Carmona-Bayonas A, Calvo-Temprano D, Jiménez-Fonseca P, Fenoy F, Benegas M, Sánchez M, Font C et al. Eur J Radiol. 2017 Feb;87:66-75.

Clinical features and short-term outcomes of cancer patients with suspected and unsuspected pulmonary embolism: the EPIPHANY study. Font C, Carmona-Bayonas A, Beato C, Reig Ò, Sáez A, Jiménez-Fonseca P et al; Asociación para la Investigación de la Enfermedad Tromboembólica de la región de Murcia. Eur Respir J. 2017 Jan 4;49(1).

Ibandronate for the prevention of bone loss after allogeneic stem cell transplantation for hematologic malignancies: a randomized-controlled trial. Lu H, Champlin RE, Popat U, Pundole X, Escalante CP, Wang X et al. Bonekey Rep. 2016 Oct 19;5:843.

The Clinical Course of Venous Thromboembolism May Differ According to Cancer Site. Mahé I, Chidiac J, Bertoletti L, Font C, Trujillo-Santos J, Peris M et al; RIETE investigators. Am J Med. 2017 Mar;130(3):337-347.

Outcome during and after anticoagulant therapy in cancer patients with incidentally found pulmonary embolism. Peris M, Jiménez D, Maestre A, Font C, Tafur AJ, Mazzolai L et al; RIETE Investigators. Eur Respir J. 2016 Nov;48(5):1360-1368.

On the necessity of new decision-making methods for cancer-associated, symptomatic, pulmonary embolism. Carmona-Bayonas A, Font C, Jiménez-Fonseca P, Fenoy F, Otero R, Beato C et al; Asociación de Investigación de la Enfermedad Tromboembólica de la Región de Murcia. Thromb Res. 2016 Jul;143:76-85.

Home management of acute medical complications in cancer patients: a prospective pilot study. Font C, Fernández-Avilés F, Calderon C, García-Fernández T, Arab N, Pineda E, et al.Support Care Cancer 2016 May;24(5):2129-37.

Patients' Experiences of LIving with CANcer associated thrOmbosis in Spain (PELICANOS). Font C, Garcia-Fernandez T, Nelson A, Prout H, Noble S. Thromb Res. 2016 Apr;140 Suppl 1:S199.

Phlegmasia cerulea dolens and multiple recurrent thrombotic events as the presenting feature of EML4-ALK translocated non-small cell lung cancer. Fernandez-Martinez A, Font C, Selvi M, Viladot M, Paré L, Galván P. et al.  Cancer Treatment Communications, 6(2016):4-7.

Prediction of serious complications in patients with seemingly stable febrile neutropenia: Validation of the Clinical Index of Stable Febrile Neutropenia in a prospective cohort of patients from the FINITE study. Carmona-Bayonas A, Jiménez-Fonseca P, Virizuela Echaburu J, Antonio M, Font C, Biosca M, et al.  J Clin Oncol. 2015 Feb 10;33(5):465-71.

[Pulmonary embolism in patients with cancer: foundations of the EPIPHANY study]  Font C, Carmona-Bayonas A, Plasencia JM, Calvo-Temprano D, Sánchez M, Jiménez-Fonseca P et al; en representación de los Investigadores del Proyecto EPIPHANY. Med Clin (Barc). 2015 Jan;144 Suppl 1:31-7.  Spanish.

Clinical guide SEOM on venous thromboembolism in cancer patients. Muñoz Martín AJ, Font Puig C, Navarro Martín LM, Borrega García P, Martín Jiménez M; Spanish Society for Medical Oncology. Clin Transl Oncol. 2014 Dec;16(12):1079-90.

Bacteremia in adult cancer patients with apparently stable febrile neutropenia: data from a cohort of 692 consecutive episodes from a single institution. Carmona-Bayonas A, Fonseca PJ, Font C, Martínez-García J, Torrella F, Urrego E, et al. J Community Support Oncol. 2014 Sep;12(9):312-20.

Romiplostim for management of chemotherapy-induced thrombocytopenia. Support Care Cancer. Parameswaran R, Lunning M, Mantha S, Devlin S, Hamilton A, Schwartz G, Soff G. 2014 May;22(5):1217-22.

Outpatient management of pulmonary embolism in cancer: Data on a prospective cohort of 138 consecutive patients. Font C, Carmona-Bayonas A, Fernández-Martinez A, Beato C, Vargas A, Gascon P, Otero R. J Natl Compr Canc Netw. 2014 Mar 1;12(3).

Webcast

What's New in the Management of Blood Clots for Cancer Patients 
Richard J. Gralla, MD, Rekha Parameswaran, MD, David A. Slosky, MD, Carolyn Messner, DSW, MSW. 
This 2012 webcast on the management of blood clots for cancer patients is available at Cancercare.org. You can view the webcast online or download an MP3 file. Topics include new treatments for venous thromboembolism, clinical trials and treatment options, the role of the FDA, and new clinical management strategies.


Please contact the Study Group Chairs above with your questions.
MASCC Study Group Coordinator, Don Gubitosa