Management of Thrombohemorrhagic Syndromes (THS) in Hematologic Malignancies

The rate of venous thromboembolism (VTE) in patients with acute leukemia or lymphomas is comparable with that of other “high-risk ” cancer types. Chemotherapy and anti-angiogenic drugs increase the thrombotic risk in patients with lymphomas, acute leukemias and multiple myeloma (MM). Patients with hematologic malignancies often present with a hypercoagulable state or chronic disseminated intravascular coagula-tion (DIC) in the absence of active thrombosis and/or bleeding. Malignant cell procoagulant properties, cytotoxic therapies, and concomitant infections are major determinants for clotting activation in hemato-logic malignancies. In acute leukemia, clinical manifes-tations range from localized venous or arterial throm-bosis to a diffuse, life-threatening thrombohemor