ABNORMALITIES OF HEMOSTASIS AND THEIR PREVENTION IN CANCER PATIENTS

O.V. Somonova, A.V. Madzhuga, A.L. Elizarova
Federal State Budgetary Institution «The N.N. Blokhin Russian Cancer Research Center» of the Russian Academy of Medical Sciences, Moscow, Russian Federation

Venous thromboembolism (VTE) is a frequent complication associated with increased mortality in cancer patients. The basic role in pathogenesis of thrombotic complication in cancer patients is played by changes in the hemostatic system caused by the tumor itself as well as methods of treatment. The use of LMWH preparations before and after operation (7–20 days) reduces the activation of pro-coagulation (prolongation of APTT, decrease in prothrombin activity and of fibrinogen concentration) and platelet links of hemostatic system, the level of intravascular coagulation markers (D-dimers, fibrin monomers soluble complex) and von Willebrand factor. The LMWH preparations conduce preservation of natural inhibitors of thrombin (antithrombin III, protein C), maintain the defensive role of fibrinolysis. In patients with tumors of the musculoskeletal system VTE developed in 13% of cases in control group versus 2% of cases in group, receiving enoxaparin sodium thromboprophylaxis. In gynecological cancer patients VTE developed in 13% of cases in control group versus 6% of cases in group, receiving nadroparin thromboprophylaxis, and 5% of cases in group, receiving enoxaparin sodium thromboprophylaxis.
Keywords: 
cancer patients, hemostasis, thrombosis, LMWH