Cancer-related thrombosis: impact of biological sex on the risk of rethrombosis and bleeding

Patients with cancer have a higher risk of re-thrombosis and bleeding secondary to anticoagulant treatment than have individuals without cancer. Given the lack of specific clinical trials, the decision regarding the optimal duration of treatment must consider multiple factors, including sex. The current study used data from the international, prospective TESEO Registry that includes consecutive patients diagnosed with cancer-associated thrombosis. Between July 2018 and December 2022, 2,823 patients were included in the TESEO Registry, 1,351 (48%) of whom were female. The most common venous thromboembolic event (VTE) in both sexes was pulmonary embolism, with an incidence of 58.0% among men and 54.3% in women (P=0.045). After a median follow-up of 6.9 months (interquartile range, 1.9-14.4), the re-thrombosis rate at the end of follow-up was 10.0% in males and 15.0% in females (P=0.14). The location of the primary tumor in the gastrointestinal tract was associated with a greater risk of re-thrombosis, whereas sex had no significant impact. Men had twice as many major bleeds. Additional risk factors for major bleeding included situations of risk due to tumor site or thrombocytopenia, as well as the presence of active tumor bleeding at the time of VTE diagnosis. Overall survival was longer among women. Given the higher incidence of major bleeding among men, sex should be deemed a relevant factor when deciding the duration of anticoagulant treatment in cancer patients.

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Publication Details

Journal
Haematologica
Published
2024-12-12
DOI
https://doi.org/10.3324/haematol.2024.286152
Primary Topic
Venous Thromboembolism Diagnosis and Management
Type
article
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article

Cancer-related thrombosis: impact of biological sex on the risk of rethrombosis and bleeding

Purificación Martínez del Prado, Marta García de Herreros, Eva Martínez de Castro, Ignacio Escobar et al.
Haematologica
Venous Thromboembolism Diagnosis and Management
article

Cancer-related thrombosis: impact of biological sex on the risk of rethrombosis and bleeding

Purificación Martínez del Prado, Marta García de Herreros, Eva Martínez de Castro, Ignacio Escobar, Laura Ortega, Pedro Pérez‐Segura, David Marrupe, Marta Campos, Fernando Neria, Alberto Carmona‐Bayonas, Isaura Fernández Pérez, Andrés Jesús Muñoz Martín, Rut Porta Balanyà, Paula Jiménez‐Fonseca, Silvia García Adrián, José Muñoz-Langa, Jaime Rubio, Manuel Sánchez Cánovas, Claudia Iglesias Pérez, Ma José Méndez Vidal, María Esperanza Guirao García
article en

Abstract

Patients with cancer have a higher risk of re-thrombosis and bleeding secondary to anticoagulant treatment than have individuals without cancer. Given the lack of specific clinical trials, the decision regarding the optimal duration of treatment must consider multiple factors, including sex. The current study used data from the international, prospective TESEO Registry that includes consecutive patients diagnosed with cancer-associated thrombosis. Between July 2018 and December 2022, 2,823 patients were included in the TESEO Registry, 1,351 (48%) of whom were female. The most common venous thromboembolic event (VTE) in both sexes was pulmonary embolism, with an incidence of 58.0% among men and 54.3% in women (P=0.045). After a median follow-up of 6.9 months (interquartile range, 1.9-14.4), the re-thrombosis rate at the end of follow-up was 10.0% in males and 15.0% in females (P=0.14). The location of the primary tumor in the gastrointestinal tract was associated with a greater risk of re-thrombosis, whereas sex had no significant impact. Men had twice as many major bleeds. Additional risk factors for major bleeding included situations of risk due to tumor site or thrombocytopenia, as well as the presence of active tumor bleeding at the time of VTE diagnosis. Overall survival was longer among women. Given the higher incidence of major bleeding among men, sex should be deemed a relevant factor when deciding the duration of anticoagulant treatment in cancer patients.

HaematologicaVol. 110(7)
Universidad de Oviedo (ES), Universidad Francisco de Vitoria (ES), University Hospital Complex Of Vigo (ES), Hospital General Universitario Gregorio Marañón (ES), Hospital Clínico San Carlos (ES), Hospital General Universitario Morales Meseguer (ES), Hospital de Basurto (ES), Complejo Hospitalario Universitario de Santiago (ES), Institut Català d'Oncologia (ES), Sociedad Española de Medicina de Familia y Comunitaria (ES), Instituto de Investigación Marqués de Valdecilla (ES), Hospital Clínic de Barcelona (ES), Hospital Arnau de Vilanova (ES), Toledo Clinic Cancer Center (US), Hospital Universitario Reina Sofía (ES), Hospital Universitario Fundación Jiménez Díaz (ES), Hospital Universitario Central de Asturias (ES), Hospital Universitario de Móstoles (ES), Complejo Hospitalario Universitario de Toledo (ES), Hospital Universitario de Toledo (ES), Universidad de Murcia (ES)
Sociedad Española de Oncología Médica
Good health and well-being
Openalex Percentile: Top 54%
Venous Thromboembolism Diagnosis and Management
DOIOpen Access PDFOpenAlex
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