OncohematologyOncohematologyОнкогематология1818-83462413-4023Publishing House ABV Press50310.17650/1818-8346-2021-16-4-40-49SUPPORTIVE THERAPY ASPECTSАСПЕКТЫ ПОДДЕРЖИВАЮЩЕЙ ТЕРАПИИPrevention and treatment of thrombosis in cancer and oncohematological patientsПрофилактика и лечение тромбозов у онкологических и онкогематологических больныхhttps://orcid.org/0000-0003-4706-2439SomonovaO. V.СомоноваО. В.
Russian Federation

Oksana Vasil’evna Somonova

24 Kashirskoe Shosse, Moscow 115478, Russia

Оксана Васильевна Сомонова

Россия, 115478 Москва, Каширское шоссе, 24

somonova@mail.ruhttps://orcid.org/0000-0001-6975-4562ElizarovaA. L.ЕлизароваА. Л.
Russian Federation

24 Kashirskoe Shosse, Moscow 115478, Russia

Россия, 115478 Москва, Каширское шоссе, 24

DavydovaT. V.ДавыдоваТ. В.
Russian Federation

24 Kashirskoe Shosse, Moscow 115478, Russia

Россия, 115478 Москва, Каширское шоссе, 24

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of RussiaФГБУ «Национальный медицинский исследовательский центр онкологии им. Н. Н. Блохина» Минздрава России111120211641011202110112021https://oncohematology.abvpress.ru/ongm/article/view/503

The purpose of the review is to highlight the current possibilities for the prevention and treatment of venous thrombotic complications in patients with cancer.

The data of 52 scientific sources published in the Russian and foreign press in 1997–2020 are considered.

Cancer patients are at high risk of thrombotic complications, which worsen the outcome of anticancer treatment and are one of the leading causes of death. Thrombosis in an oncological patient increases the risk of death by 30 times, which is associated with fatal thromboembolism and a more aggressive course of the disease. The leading role in the pathogenesis of thrombotic complications is played by disorders in the hemostasis system caused both by the tumor itself and by therapy. Low molecular weight heparins are considered the basis for specific prophylaxis of thromboembolic complications in cancer patients. The use of low molecular weight heparins after surgery and during chemotherapy effectively reduces the incidence of venous thrombosis. Direct oral anticoagulants are promising drugs for oral administration and are indicated as one of the treatment options for patients with tumor-associated thrombosis with a low risk of bleeding and no drug interactions with ongoing systemic chemotherapy.

Цель обзора – осветить современные возможности профилактики и лечения венозных тромботических осложнений у пациентов с онкологическим заболеванием.

Рассмотрены данные 52 научных источников, опубликованных в российской и зарубежной печати в 1997–2020 гг.

Онкологические больные подвержены высокому риску тромботических осложнений, которые ухудшают исходы противоопухолевого лечения и занимают одно из лидирующих мест среди причин смерти. Тромбоз у онкологического пациента увеличивает риск смерти в 30 раз, что связано с развитием смертельной тромбоэмболии и более агрессивным течением опухолевого процесса. Ведущую роль в патогенезе тромботических осложнений играют нарушения в системе гемостаза, вызываемые как непосредственно опухолью, так и методами лечения. Основой специфической профилактики тромбоэмболических осложнений у онкологических больных считают низкомолекулярные гепарины. Применение низкомолекулярных гепаринов после операции и на фоне химиотерапии эффективно снижает частоту венозных тромбозов. Прямые оральные антикоагулянты являются перспективными препарата‑ ми для приема внутрь и показаны в качестве одного из вариантов терапии пациентов с опухоль-ассоциированными тромбозами при низком риске кровотечения и отсутствии лекарственных взаимодействий с проводимой системной химиотерапией.

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