The role of histopathological examination, therapeutic difficulties and thromboembolism treatment during palliative chemotherapy in patient with antithrombin deficiency, colon cancer and endometrial cancer

• Authors: Katarzyna Kryszczyszyn-Musialik , Ludmiła Dolczak , Grzegorz Słomian
• Languages of publication: EN

Abstracts

EN

Palliative chemotherapy in patients with thrombophilia is a challenge for clinical oncologists. On one hand the optimal treatment should be very safe for patient, on the other hand – as effective as possible. That therapy is also connected with proper thromboprophylaxis. The incidence of multiple cancers is a serious problem of modern oncology. In patients whose medical history includes two or more cancers, it is essential to obtain histopathological diagnosis before the administration of treatment of disseminated disease. It allows to avoid improper therapy which is often toxic. The article presents the case of a patient with antithrombin deficiency and two cancers in medical history: colon cancer and endometrial cancer. The treatment of the patient because of the metastatic cancer was started after the histopathological diagnosis. In metastatic lymph node the endometrial cancer was recognized. The carboplatin and paclitaxel were used in the therapy. The treatment was conducted in four course chemotherapy. It revealed considerable polyneuropathy and hematologic toxicity limiting from further therapy. Treatment allowed to obtain biochemical response, decrease of metastases and the condition of a patient improved. During the systemic therapy thromboprophylaxis with acenocumarol was used. The incidence of venous thromboembolism or bleeding complications were not noticed.

Keywords

EN

antithrombin deficiency   colon cancer   endometrial cancer   multiple cancers   palliative chemotherapy   thromboprophylaxis  

Discipline

• MEDICINE: MEDICINE

• Publisher: Medical Education
• Journal: OncoReview
• Year: 2017
• Volume: 7
• Issue: 1
• Pages: 28-31

References

• 1. Hellman A. Choroby układu krwiotwórczego. In: Gajewski P. (ed). Interna Szczeklika 2015. Medycyna Praktyczna, Kraków 2015: 1842-1845.
• 2. Szymańska M, Alhenc-Gelasb M, Undas A. Antithrombin Rybnik: a new point mutation (nt 683 G>T) associated with type I antithrombin deficiency in a patient with venous thromboembolism and recurrent superficial venus thrombosis. Blood Coagul Fibrinolysis 2013; 24: 579-580.
• 3. Szymańska M, Wypasek E, Undas A. Niedobór antytrombiny – problemy diagnostyki laboratoryjnej. Diagn Lab 2013; 49(2): 145-152.
• 4. Wojtukiewicz MZ, Sierko E, Tomkowski W et al. Guidelines for treatment of venosus thromboembolism in patients with cancers treated conservatively. Oncol Clin Pract 2016; 12: 67-91.
• 5. Potemski P, Krzakowski M. Leczenie wspomagające. In: Krzakowski M, Warzocha K (ed). Zalecenia postępowania diagnostyczno-terapeutycznego w nowotworach złośliwych 2013 rok. Via Medica, Gdańsk 2013: 558-567.
• 6. Blann AD, Dunmore S. Arterial and Venous Thrombosis in Cancer Patients. Cardiology Research and Practice 2011; 2011: 394740. doi: 10.4061/2011/394740.
• 7. Kirwan CC , McCollum CN, McDowell G et al. Investigation of proposed mechanisms of chemotherapy-induced venous thromboembolism: endothelial cell activation and procoagulant release due to apoptosis. Clin Appl Thromb Hemost 2015; 21: 420-427.
• 8. L eBlanc TW, McNeil M., Kamal AH et al. Polypharmacy in patients with advanced cancer and the role of medication discontinuation. Lancet Oncol 2015; 16(7): e333-341.
• 9. Saccullo G, Malato A, Raso S. et al. Cancer patients requiring interruption of long-term warfarin because of surgery or chemotherapy induced thrombocytopenia: The use of fixedsub-therapeutic doses of low-molecular weight heparyn. Am J Hematol 2012; 87: 388-391.
• 10. Domagała-Haduch M, Jasiówka M, Nowak Ł et al. Complications of palliative antiangiogenic therapy in patients with colorectal cancer. OncoReview 2016; 6: 199-204.
• 11. Świątoniowski G, Brużewicz S, Kłaniewski T. Radykalne leczenie chorej z trzema nowotworami złośliwymi. Onkol Prak Klin 2008; 4: 107-109.

• Document Type: article