Thrombosis research
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Thrombosis research · Apr 2010
ReviewAntimetastatic activities of heparins and modified heparins. Experimental evidence.
Heparin is commonly used for prevention or treatment of cancer-associated thromboembolism. Recent clinical evidence indicates that heparin, and low-molecular weight heparin improves survival of cancer patients. ⋯ The delineation of antimetastatic activity of heparin is in the focus of several ongoing investigations. This review summarizes the current experimental evidence on the biology of heparin as a potential treatment cancer progression.
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Thrombosis research · Apr 2010
ReviewLessons from French National Guidelines on the treatment of venous thrombosis and central venous catheter thrombosis in cancer patients.
Increased prevalence of Venous thromboembolism (VTE), as defined by deep-vein thrombosis (DVT), central venous catheter (CVC) related thrombosis or pulmonary embolism (PE) in cancer patients has become a major therapeutic issue. Considering the epidemiology and each national recommendations on the treatment of VTE in cancer patients, we analysed guidelines implementation in clinical practice. Thrombosis is the second-leading cause of death in cancer patients and cancer is a major risk factor of VTE, due to activation of coagulation, use of long-term CVC, the thrombogenic effects of chemotherapy and anti-angiogenic drugs. ⋯ The Italian Association of Medical Oncology (AIOM), the National Comprehensive Cancer Network (NCCN), the American Society of Clinical Oncology (ASCO), the French "Institut National du Cancer" (INCa), the European Society of Medical Oncology (ESMO) and the American College of Chest Physicians (ACCCP) have published specific guidelines for health care providers regarding the prevention and treatment of cancer-associated VTE. Critical appraisal of these guidelines, difficulties in implementation of prophylaxis regimen, tolerance and cost effectiveness of long term use of LMWH may account for large heterogenity in daily clinical practice. Homogenization of these guidelines in international consensus using an adapted independent methodological approach followed by educational and active implementation strategies at each national level would be very valuable to improve the care of VTE in cancer patients.
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Thrombosis research · Apr 2010
ReviewFuture directions in hemostasis: normalizing the lives of patients with hemophilia.
The ultimate goal of hemophilia research is to cure the disease by permanently replacing the abnormal or deficient clotting factor. The most promising current approach is to insert a functional gene into the patient that will lead to the production of either the native protein or a compatible non-immunogenic equivalent version. This protein will circulate at adequate levels to prevent spontaneous bleeds and to treat traumatic hemorrhage. ⋯ Ease of administration may be accomplished by the introduction of room temperature stable products and the development of subcutaneous and even orally administered therapeutics. It is conceivable that a broad spectrum hemostatic agent capable of normalizing thrombin generation in a variety of deficiencies could be developed. If this is accomplished, the steps to a room temperature stable agent, contained within a pre-filled pen, capable of self-delivery by subcutaneous injection are already within the realm of current developmental capabilities.