Optimal management of venous thromboembolism in adolescent and young adult oncology patients

Abstract

Optimal management of venous thromboembolism in adolescent and young adult oncology patients Sarah McKillop,1 Cynthia Wu,2 Aisha Bruce,1 Joseph Brandwein2 1Division of Immunology, Hematology, Oncology, Palliative Care and Environmental Medicine, Department of Pediatrics, 2Division of Hematology, Department of Medicine, University of Alberta, Edmonton, AB, Canada Abstract: Venous thromboembolism (VTE) is a serious complication experienced by adolescents and young adults (AYAs) diagnosed with cancer. Data exist in the adult literature to guide the management of cancer-associated thrombosis. Unfortunately, little is known regarding the epidemiology of cancer-associated thrombosis in AYAs. As a result, evidence on the treatment and prevention of thrombosis in this vulnerable population is lacking, posing a great challenge to physicians caring for AYAs with cancer. It is clear that the basic principles of VTE likely apply to AYAs and that low-molecular-weight heparin is the drug of choice for the treatment of VTE regardless of age. We review the available data on the epidemiology, diagnostic methods, and management of AYAs with cancer and VTE. Recognizing the lack of accepted guidelines for the prevention or management of VTE in this population, we offer expert opinion recommendations to serve as guidance to improve management of thrombosis in AYA cancer patients. Keywords: adolescents, young adults, thrombosis, cancer, venous thromboembolism, anticoagulation