Thrombus - 2015

Cancer-associated thrombosis guidelines
Annie Young and Anand Lokare
pp 49-52
Cancer and thrombosis are inextricably linked. Blood coagulation has a profound impact on cancer, including the manifestations of the tumour biology and host response,1which will ultimately translate into individualised patient care. Patients with cancer frequently have to deviate from their planned treatment after the development of thrombosis, and having both cancer and a clot is a burden with a significant adverse effect on quality of life, as well as being a poor prognostic sign.
Comment: The All-Party Parliamentary Thrombosis Group and CAT – a cart before the horse?
Peter Rose
pp 50-50
The All-Party Parliamentary Thrombosis Group reported in October that in 2.6% of patients whose death certificate listed cancer in the past three years, venous thromboembolism (VTE) was also listed as a cause of death. It is laudable of the group to turn its attention to cancer-associated thrombosis (CAT) and increase awareness among clinicians and patients of VTE in the cancer setting. While CAT is not a new revelation, it is encouraging to see it as a new priority.
Improving access to management guidelines: the GSTT Thrombosis app
Rebecca Chanda, Christopher N Floyd, Steven E Williams and Beverley J Hunt
pp 53-55
The Guy’s and St Thomas’ NHS Foundation Trust Thrombosis and Thromboprophylaxis Committee has worked hard over the years to summarise clinical guidelines in simple algorithms, after recognising that clinicians are more likely to absorb clinical information that is short and clear. The national drive to improve the prevention of hospital-acquired venous thromboembolism through the development of National Institute of Health and Care Excellence guidelines, and Commissioning for Quality and Innovation targets for at least 95% risk assessment, conferred the need for clinicians to have ready access to these guidelines at the point of clinical care. This strategy would aim to support safe and effective prescribing of anticoagulants for the prevention and management of thrombosis.
Can anticoagulation be used while breastfeeding?
Sarah Bond
pp 56-56
Breastfeeding while on warfarin is considered relatively safe. Reports have found that warfarin is not detected in the breastmilk of lactating women, and none was detectable in the serum of breastfed infants of mothers receiving warfarin. Reports have also shown no effects on bleeding time of breastfed infants whose mothers were on warfarin.
Clot Slot

pp 57-57
Clinical Leaders of Thrombosis (CLOT) is a specialist interest group for all healthcare professionals working within anticoagulation and thrombosis. With over 700 current members nationally, CLOT is a forum and platform where members are encouraged to share their research and practice, and present to colleagues at the annual conference in Birmingham. We also offer members sponsorship of up to £2,000 to help fund their research or attend an international conference, and we encourage members to write articles for the newsletter and CLOT website. We are always interested in sharing what we do with all CLOT members.
Monitoring of non-vitamin K antagonist oral anticoagulants: is there a clinical need?
Jignesh Patel
pp 58-60
History has taught us that when therapeutic doses of an anticoagulant are prescribed, a form of dose individualisation is required to ensure both treatment efficacy and patient safety. Anticoagulants are agents with a narrow therapeutic index. That is, they have a fine line between efficacy and toxicity. Individualisation can include dose adjustment based on laboratory testing; for example, the International Normalised Ratio for warfarin or bodyweight for low molecular weight heparins.
Obstetric venous thromboembolism: what I tell my patients
Karyn Longmuir
pp 61-63
Pulmonary embolism remains the leading direct cause of maternal mortality in the developed world and deep vein thrombosis is a significant cause of both short- and longterm maternal morbidity. The latest triennial report Saving Lives, Improving Mothers’ Care, published in 2014, quotes mortality rates due to thrombosis and thromboembolism of 1.08–1.26 per 100,000 pregnancies in the period 2009–12. In the UK, 30 women died from thrombosis between 2009 and 2011. The detailed report into deaths related to thrombosis is expected later this year.

Thrombus was previously supported by Bayer from 2014 to 2016, by Boehringer Ingelheim from 2009 to 2013, by sanofi-aventis from 2007 to 2008 and by Leo Pharma from 1998 to 2006.

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ISSN 1369-8117 (Print)  ISSN 2045-7855 (Online)