Direct oral anticoagulants vs. low-molecular-weight heparin for pulmonary embolism in patients with glioblastoma

  • Glioblastoma (GBM) is a cancer type with high thrombogenic potential and GBM patients are therefore at a particularly high risk for thrombotic events. To date, only limited data on anticoagulation management after pulmonary embolism (PE) in GBM is available and the sporadic use of DOACs remains off-label. A retrospective cohort analysis of patients with GBM and postoperative, thoracic CT scan confirmed PE was performed. Clinical course, follow-up at 6 and 12 months and the overall survival (OS) were evaluated using medical charts and neuroradiological data. Out of 584 GBM patients, 8% suffered from postoperative PE. Out of these, 30% received direct oral anticoagulants (DOACs) and 70% low-molecular-weight heparin (LMWH) for therapeutic anticoagulation. There was no significant difference in major intracranial hemorrhage (ICH), re-thrombosis, or re-embolism between the two cohorts. Although statistically non-significant, a tendency to reduced mRS at 6 and 12 months was observed in the LMWH cohort. Furthermore, patients receiving DOACs had a statistical benefit in OS. In our analysis, DOACs showed a satisfactory safety profile in terms of major ICH, re-thrombosis, and re-embolism compared to LMWH in GBM patients with postoperative PE. Prospective, randomized trials are urgent to evaluate DOACs for therapeutic anticoagulation in GBM patients with PE.
Author:Daniel DubinskiORCiDGND, Sae-Yeon WonORCiDGND, Martin VoßORCiDGND, Fee KeilORCiDGND, Wolfgang MiesbachORCiDGND, Bedjan BehmaneshORCiDGND, Max DoschORCiD, Peter BaumgartenORCiDGND, Joshua D. BernstockORCiD, Volker SeifertORCiD, Thomas Michael FreimanORCiDGND, Florian GeßlerORCiDGND
Parent Title (English):Neurosurgical review
Place of publication:Berlin ; Heidelberg ; New York
Document Type:Article
Date of Publication (online):2021/04/26
Date of first Publication:2021/04/26
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2022/07/12
Tag:Direct oral anticoagulation; Glioblastoma survival; Low-molecular-weight heparin; Pulmonary embolism; Therapeutic anticoagulation
Page Number:7
First Page:451
Last Page:457
Open Access funding enabled and organized by Projekt DEAL.
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung 4.0