sP-selectin and D-dimer used to predict VTE risk in cancer patients

Cancer patients have a higher risk for VTE, but should they all receive anticoagulation therapy? When is pharmacological prophylaxis warranted?  A recent published paper seems to suggest that sP-selectin and D-dimer may be used to help predict VTE risk in cancer patients.

Here's the abstract:

The risk of venous thromboembolism (VTE) is increased in cancer patients. To improve prediction of VTE in cancer patients, we performed a prospective and observational cohort study of patients with newly diagnosed cancer or progression javascript:void(0)of disease after remission. A previously developed risk scoring model for prediction of VTE that included clinical (tumour entity and body-mass-index) and laboratory (hemoglobin level, thrombocyte- and leucocyte-count) parameters was expanded by incorporating two biomarkers, soluble P-selectin and D-dimer. Of 819 patients 61 (7.4%) experienced VTE during a median follow-up of 656 days. The cumulative VTE probability in the original risk model after 6 months was 17.7% in patients with the highest risk score (≥3, n=93), 9.6% in those with score 2 (n=221), 3.8% in those with score 1 (n=229) and 1.5% in those with score 0 (n=276). In the expanded risk model, the cumulative VTE probability after 6 months in patients with the highest score (≥5, n=30) was 35.0% and 10.3% in those with an intermediate score (score 3, n=130) as opposed to only 1.0% in patients with score 0 (n=200); the hazard ratio of patients with the highest compared to those with the lowest score was 25.9 (8.0-84.6). Clinical and standard laboratory parameters with addition of biomarkers enable prediction of VTE and allow identification of cancer patients at high or low risk of VTE.

Ay C, Dunkler D, Marosi C, Chiriac AL, Vormittag R, Simanek R, Quehenberger P, Zielinski C, Pabinger I. Prediction of venous thromboembolism in cancer patients. Blood. 2010 Sep 9.

Click here to read the abstract.