Highlights
- •The optimal therapy of VTE in patients with glioblastoma multiforme is unknown.
- •They had a higher rate of recurrent PE and major bleeding than those without cancer.
- •Their outcome was similar to that in patients with other cancers.
Abstract
Background
There is uncertainty about the optimal therapy of venous thromboembolism (VTE) in
patients with glioblastoma multiforme (GBM).
Methods
We used the RIETE (Registro Informatizado Enfermedad TromboEmbólica) database to compare
the rate of VTE recurrences and major bleeding during the course of anticoagulation
in patients with GBM, other cancers and in patients without cancer.
Results
As of September 2014, 53,546 patients have been recruited in RIETE. Of these, 72 (0.13%)
had GBM and 11,811 (22%) had other cancers. Most patients in all 3 subgroups received
initial therapy with low-molecular-weight heparin (LMWH), but those with GBM received
slightly lower doses than those with other cancers or without cancer. Then, most patients
with GBM continued on LMWH for long-term therapy, at similar doses than those in the
other subgroups. During the course of anticoagulation (mean, 202 days), 3 patients with GBM presented VTE recurrences (10.9 per 100 patient-years;
95% CI: 2.76–29.5) and 4 suffered major bleeding (one intracranial) (14.5 bleeds per
100 patient-years; 95%CI: 4.60–34.9). Compared with patients with other cancers, those
with GBM had a similar rate of VTE recurrences and major bleeds, but had a higher
rate of extracranial hematoma (p < 0.05). Compared with VTE patients without cancer, those with GBM had a higher rate
of PE recurrences (p < 0.01) and major bleeding (p < 0.001), particularly extracranial hematoma (p < 0.001).
Conclusions
Patients with GBM and VTE had a similar rate of VTE recurrences or major bleeds during
the course of anticoagulant therapy than those with other cancers.
Keywords
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Article info
Publication history
Published online: October 29, 2015
Accepted:
October 29,
2015
Received in revised form:
October 5,
2015
Received:
August 26,
2015
Identification
Copyright
© 2015 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
