In Search of the Appropriate Anticoagulant-Associated Bleeding Risk Assessment Model for Cancer-Associated Thrombosis Patients

Géraldine Poénou; Emmanuel Tolédano; Hélène Helfer; Ludovic Plaisance; Florent Happe; Edouard Versini; Nevine Diab; Sadji Djennaoui; Isabelle Mahé

doi:10.3390/cancers14081937

In Search of the Appropriate Anticoagulant-Associated Bleeding Risk Assessment Model for Cancer-Associated Thrombosis Patients

Cancers (Basel). 2022 Apr 12;14(8):1937. doi: 10.3390/cancers14081937.

Authors

Géraldine Poénou¹, Emmanuel Tolédano^{1

2}, Hélène Helfer¹, Ludovic Plaisance¹, Florent Happe¹, Edouard Versini^{1

2}, Nevine Diab^{1

2}, Sadji Djennaoui¹, Isabelle Mahé^{1

2

3

4}

Affiliations

¹ Médecine Interne, Hôpital Louis Mourier, Assistance Publique Hôpitaux de Paris, 92700 Colombes, France.
² Université de Paris Cité, 75006 Paris, France.
³ Unité Inserm UMR-S1140 Innovation Thérapeutique en Hémostase, 75006 Paris, France.
⁴ INNOVTE-FCRIN, CEDEX 2, 42055 Saint-Etienne, France.

Abstract

Patients with venous thromboembolism events (VTE) in the context of cancer should receive anticoagulants as long as the cancer is active. Therefore, a tailor-made anticoagulation strategy should rely on an individualized risk assessment model (RAM) of recurrent VTE and anticoagulant-associated bleeding. The aim of this review is to investigate the applicability of the currently available RAMs for anticoagulant-associated bleeding after VTE in the CAT population and to provide new insights on how we can succeed in developing a new anticoagulant-associated bleeding RAM for the current medical care of CAT patients. A systematic search for peer-reviewed publications was performed in PubMed. Studies, including systematic reviews, 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. Out of 15 RAMs, just the CAT-BLEED was developed for CAT patients and none of the presented RAMs developed for the VTE general population were externally validated in a population of CAT patients. The current review illustrates the limitations of the available RAMs for anticoagulant-associated bleeding in CAT patients. The development of a RAM for bleeding risk assessment in patients with CAT is warranted.

Keywords: bleeding; cancer associated thrombosis; risk assessment model.

Publication types

Review