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Antineoplastic infusion induces hypercoagulability But the effect is abolished by heparin

Patients with cancer have a relatively high incidence of thromboembolic events 1'5 the general population. Furthermore, the common loss of venous access after infusion of antineoplastics suggests that the treatment of cancer can further exacerbate hypercoagulability.

16 patients with advanced or metastatic cancer received infusions of antineoplastic agents, and 8 of them received a second antineoplastic infusion ~ 7 days later. Second infusions were immediately preceded by heparin 5000U through the ' same venous access port.

Blood samples were drawn from the contralateral arm and were assessed using plasma fibrinopeptide A levels as a measure of blood coagulability. 14 of 16 patients had fibrinopeptide A levels above the normal range before drug administration , and levels were further elevated 45min after the antineoplastic infusion . Heparin pretreatment abolished the antineoplastic-induced rise in fibrinopeptide A levels.

'Larger trials will be necessary to determine if routine prophylactic anticoagulation limited to the immediate period of chemotherapy administration would reduce the incidence of thrombosis and allow better retention of I'enous access in patients with cancer.'

Ed wards KL. Klaus M. Mathews E. McCullen C. Ro na RD. ct a l. Hepa rin aholi shes the chem o the rapy-induced increase in plasma lihrinopeptidc A lew is. America n .Iourna l o f Medicine 8'1: 25-28. Jul 1990

25 Aug 1990 INPHARMA ® ISSN 0156-2703/90/0825-0018/ 0$01.00/ 0 © Adis International Ltd