ABSTRACT
Malignancy is an acquired thrombophilic condition that significantly increases the
risk of thrombosis. Both venous and arterial thromboembolisms are recognized complications
in patients with cancer. In addition, clotting activation may have a role in tumor
progression. The pathogenesis of thrombophilia in cancer is multifactorial; however,
an important role is attributed to the tumor cell capacity to interact with and activate
the host hemostatic system. Recently, new strategies to prevent and cure thrombosis
in cancer have become available, thus improving the management of thrombotic complications
in the malignant disease. An antineoplastic effect of anticoagulant agents has also
been suggested. Both heparins and vitamin K antagonists have been tested in this context.
Heparins have been more extensively studied. Recently, the results of prospective,
randomized clinical trials to evaluate the effect of low-molecular-weight heparin
on cancer survival have created new interest in this area. The published data are
promising and provide new information in the research knowledge in this field. The
potential anticancer activity of heparins is supported by data from in vitro and experimental
studies.
KEYWORDS
Cancer - heparin - LMWH - UFH - survival - tumor procoagulants - angiogenesis - metastasis
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Anna FalangaM.D.
Department of Hematology, Ospedali Riuniti di Bergamo
Largo Barozzi, 1 24128 Bergamo, Italy
eMail: annafalanga@yahoo.com