Hemostasis

Leadership

CHAIR Carmen Escalante, MD USA

VICE-CHAIR Thomas Butler, MD USA

VICE-CHAIR Carme Font, MD Spain

Mission and Goals

•  Keep up to date with current guideline regarding treating cancer patients with bleeding and clotting problems related to their disease
•  Evaluate current guidelines for their merit and deficiencies in providing adequate treatment to cancer patients with coagulation problems
•  Promote multinational and multidisciplinary cooperative networks among those involved in the care of cancer patients with thrombotic and bleeding complications; including physicians, nurses, pharmacists, psychologists, and other professionals involved in patient education
•  Focus on anticoagulation treatment and quality of life in cancer patients in different settings during the cancer journey: VTE prevention and management; outpatient and inpatient settings; VTE and bleeding complications in patients receiving active cancer-specific treatments as well as those receiving palliative care

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

Guideline Development Project: Reviewers Needed

MASCC/ISOO Guidelines for Preventing Cancer-Associated Thrombosis (CAT)
The Study Group is in the process of developing clinical practice guidelines for the prevention of cancer-associated thrombosis. The goals of the project are to review the recent literature, make recommendations for the prevention of venous thrombosis, and develop educational tools about cancer-associated thrombosis. Reviewers are needed to assist with literature review and to provide input as we work toward completing the guidelines. This is a great opportunity to get involved with the work of the Study Group. For more details and contact information, see Hemostasis Guideline Project.

Now Recruiting Participants!

Treatment Adherence, Quality of Life, and Resource Utilization during Anticoagulant Therapy for Cancer-Related VTE
Cristhiam Rojas Hernandez, a member of the Hemostasis Study Group, is the principal investigator of a clinical research project titled “Measurement of Adherence and Health-related Quality of Life, and Health-care Resource Utilization during Anticoagulation Therapy in Cancer-related Venous Thromboembolism.” The objectives of the study are to assess self-reported adherence and the HRQL change at different long-term time points during anticoagulation treatment of cancer-related VTE associated with different anticoagulation strategies. For eligibility criteria and contact information, see VTE Treatment Adherence Study.

Past Workshop3

2017 Annual Meeting Workshop, June 22, Washington, DC • Update on Venous Thromboembolism: Approach and Challenges
This workshop, held jointly by the Hemostasis and Education Study Groups, brought together a multinational group of experts to review current evidence and needed knowledge regarding cancer-associated venous thromboembolism (VTE). It included discussions of the clinical challenges and promoted the education of patients, providers, and family members. Workshop presentations are listed below and slide sets are available for review. Workshop Chairs: Carme Font, Carmen Escalante, Thomas Butler, Paz Fernández-Ortega

Workshop Presentations & Slides

Primary Thromboprophylaxis for Cancer Outpatients on Chemotherapy: Case Study
Carme Font, MD, Medical Oncology Department, Hospital Clinic Barcelona, Barcelona, Spain

Primary Thromboprophylaxis in Ambulatory Cancer Patients: Current Guidelines and Updated Evidence
Taylor Butler, PharmD, BCOP, Department of Veteran Affairs, Tennessee Valley Healthcare System, Nashville, Tennessee, USA

Patient-Centered Treatment of Cancer-Associated VTE. Does One Size Fit All?

Shared Decision-Making in Anticoagulation: Patient, Provider, Family / Friends
Annie Young, University of Warwick and University Hospitals Coventry and Warwickshire, Great Britain, UK

Update on Direct Oral Anticoagulants: A Perspective Beyond the Cancer VTE Guidelines
Chrishiam M. Rojas-Hernandez, MD, MD Anderson Cancer Center, Houston, Texas. USA

Challenging Case Study: VTE Treatment — “How Long Is Long Enough?”
Thomas W. Butler, MD, FACP, University of South Alabama, Mitchell Cancer Institute, Mobile, Alabama, USA

Best Practices: Approaches to Educating and Engaging Patients on VTE Prevention
by Judy Phillips, DNP, FNP-BC, AOCN, Cancer Care of Western North Carolina, Lenoir-Rhyne University, North Carolina, USA

Recent Member Publications

Recent Study Group member publications related to bleeding and clotting complications in cancer patients.

Practice Resources: Guidelines

National Comprehensive Cancer Network Guidelines on Cancer-Associated Venous Thromboembolic Disease

American Society of Clinical Oncology Venous Thromboembolism Prophylaxis and Treatment in Patients With Cancer Update

Management of Venous Thromboemtolism (VTE) in Cancer Patients: ESMO Clinical Practice Guidelines

Evaluation of Patients With Suspected Acute Pulmonary Embolism: Best Practice Advice From the Clinical Guidelines Committee of the American College of Physicians (not specifically for cancer patients)

Antithrombotic Therapy for VTE Disease: CHEST Guideline and Expert Panel Report (not exclusively for cancer patients)

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.