High Rates of Thromboembolic Events in Patients with Germ Cell Cancer Undergoing Cisplatin-Based Polychemotherapy

Urol Int. 2016;96(4):399-405. doi: 10.1159/000445126. Epub 2016 Apr 14.

Abstract

Background: We examined whether or not extended prophylaxis with low molecular weight heparin (LMWH) would significantly reduce thromboembolic event (TEE) rates in germ cell cancer patients undergoing cisplatin-based chemotherapy.

Patients and methods: LMWH prophylaxis was given from the first day of chemotherapy until 21 days after completing the last chemotherapy cycle to 45 out of 93 (48.4%) patients (extended), and to 48 out of 93 (51.6%) patients during their hospitalization only (limited) between January 2008 and December 2013. Patients were analyzed retrospectively for TEEs such as deep vein thrombosis (DVT), pulmonary embolism (PE), myocardial infarction (MI) or peripheral arterial thrombosis.

Results: A total of 22/93 (23.7%) patients experienced 30 TEE during chemotherapy: 12 out of 30 (40%) deep vein thrombosis, 4 out of 30 (13.3%) MI, 10 out of 30 (33.3%) PE and 4 out of 30 peripheral arterial thrombosis (13.3%). TEE rates in both groups did not differ significantly (extended: 26.7 vs. limited: 20.8%).

Conclusions: The introduction of extended LMWH prophylaxis did not significantly reduce TEE rates in our patient cohort.

MeSH terms

  • Adult
  • Anticoagulants / therapeutic use*
  • Antineoplastic Agents / therapeutic use*
  • Cisplatin / therapeutic use*
  • Drug Therapy, Combination
  • Heparin, Low-Molecular-Weight / therapeutic use*
  • Humans
  • Male
  • Neoplasms, Germ Cell and Embryonal / complications
  • Neoplasms, Germ Cell and Embryonal / drug therapy*
  • Retrospective Studies
  • Testicular Neoplasms / complications
  • Testicular Neoplasms / drug therapy*
  • Thromboembolism / epidemiology*
  • Thromboembolism / etiology
  • Thromboembolism / prevention & control*

Substances

  • Anticoagulants
  • Antineoplastic Agents
  • Heparin, Low-Molecular-Weight
  • Cisplatin