Zusammenfassung
Die Assoziation von Tumorerkrankungen mit thromboembolischen Komplikationen ist seit
mehr als hundert Jahren bekannt. Während die thrombophile Diathese von Tumorpatienten
und die paraneoplastische Thrombogenese pathophysiologisch teilweise geklärt sind,
ergeben neuere Untersuchungen Hinweise dafür, dass Mediatoren der plasmatischen Hämostase
Tumorwachstum, Angiogenese und Metastasierung beeinflussen. Die Grundlage einer antithrombotischen
Prophylaxe und Therapie bei Tumorpatienten leitet sich deshalb nicht nur aus der bekannten
Thromboseneigung der Patienten ab, sondern auch aus der potenziell antineoplastischen
bzw. antimetastatischen Wirkung einer pharmakologischen Gerinnungshemmung. Erfolgversprechende
Ergebnisse klinischer Studien lassen darauf schließen, dass das Überleben ausgewählter
Tumorpatienten durch prophylaktische bzw. therapeutische Antikoagulation verbessert
werden kann.
Summary
The association of cancer with thromboembolic events has been established for more
than hundred years. While the thrombophilic diathesis of tumor patients and the neoplastic
thrombogenesis have been elucidated pathophysiologically, at least in part, there
is growing experimental and clinical evidence that factors of plasmic hemostasis promote
tumor growth, angiogenesis, and metastasis. Thus, the rationale for antithrombotic
prophylaxis and therapy of tumor patients might not only be based on the prevention
of thromboembolic complications but also on the potentially antineoplastic and antimetastatic
effects of pharmacological anticoagulation. Encouraging results of clinical studies
indicate that prophylactic and therapeutic anticoagulation might improve the survival
of selected patients with cancer.
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Priv.-Doz. Dr. M. Stockschläder
Institut für Hämostaseologie und Transfusionsmedizin, Heinrich-Heine-Universität Düsseldorf
Moorenstraße 5
40225 Düsseldorf
Phone: 0211/8116921
Fax: 0211/8116937
Email: stockschlaeder@med.uni-duesseldorf.de