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Anticoagulant associated bleeding risk assessment model for cancer associated thrombosis patients: A systematic review

1Assistance publique Hopitaux de paris, Colombes, Ile-de-France, France, 2Assistance Publique Hôpitaux de Paris, Colombes, Ile-de-France, France, 3assistance publique hôpitaux de Parus, Colombes, Ile-de-France, France, 4Assistance Publique Hôpitaux de Paris, colombes, Ile-de-France, France, 5Assistance Publique Hôpitaux de Paris, Université de Paris, 3. Unité Inserm UMR_S1140 Innovation thérapeutique en hémostase, 4. INNOVTE-FCRIN, Colombes, Ile-de-France, France

Abstract Number: VPB0944

Meeting: ISTH 2022 Congress

Theme: Venous Thromboembolism » Cancer Associated Thrombosis

Background: Patients with venous thromboembolism event (VTE) in the context of cancer should be receiving anticoagulant as long that the cancer is active. Therefore, a tailor-made anticoagulation strategy should rely on an individualized assessment of the risks of recurrent VTE and anticoagulant associated bleeding. Yet, no existing risk assessment model (RAM) for anticoagulant associated bleeding risk has been validated in cancer associated thrombosis (CAT).

Aims: The aim of this review is to investigate the currently available RAM for anticoagulant associated bleeding after VTE in their applicability in the CAT population, and to provide new insights on how we can succeed in developing a new anticoagulant associated bleeding RAM in current medical care of CAT patients.

Methods: A systematic search for peer-reviewed publications up to September 20th, 2021 was performed in PubMed. Studies were eligible if they comprised patients with VTE, and used a design for developing a prediction model, score, or other prognostic tools for anticoagulant associated bleeding during anticoagulant treatment, including systematic reviews. Studies focusing on predicting the risk of anticoagulation associated bleeding in a non-VTE based population were excluded.

Results: 15 RAMs were found in the literature. (Table 1) Just the CAT-BLEED was developed for CAT patients and none of the presented RAMs developed on VTE general population were externally validated in a population of CAT patients. By focusing on methodology and applicability for CAT patients, the current review illustrates the limitations of the available RAMs for anticoagulant associated bleeding in CAT patients. To obtain a better RAM to assess the anticoagulant-associated bleeding risk in CAT patients, we deemed it necessary to answer the questions in WHOM, HOW, WHAT, and WHEN do we assess the anticoagulant-associated bleeding risk.

Conclusion(s): The development of RAM for bleeding risk assessment in patients with CAT is warranted .

Table

Prediction factors for anticoagulant associated bleeding RAM

To cite this abstract in AMA style:

POENOU G, TOLEDANO E, HELFER H, PLAISANCE L, VERSINI e, DIAB N, DJENNAOUI S, Mahe I. Anticoagulant associated bleeding risk assessment model for cancer associated thrombosis patients: A systematic review [abstract]. https://abstracts.isth.org/abstract/anticoagulant-associated-bleeding-risk-assessment-model-for-cancer-associated-thrombosis-patients-a-systematic-review/. Accessed October 2, 2023.

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