Thrombosis and bleeding in hematological malignancy

Abstract

Venous (VTE) and arterial (ATE) thromboemboli are a leading cause of morbidity and mortality in patients with cancer. Patients with hematological malignancies are at an exceptionally high risk of both VTE and ATE. This risk varies based on patient- and disease-specific risk factors and can be predicted using risk prediction models for some types of hematological malignancies. Treatment of VTE for patients with hematological malignancies is largely based on randomized control trials that predominately enrolled patients with solid tumors. However, treatment must be balanced with the risk of anticoagulant or antiplatelet therapy in this unique patient population that can have a competing risk of bleeding. In this review, we present the evidence that addresses the risk and prediction of VTE, ATE and bleeding in patients with hematological malignancies and considerations for treatment of these conditions.