Risco de hemorragia cerebral em pacientes portadores de gliomas de alto grau e anticoagulados
DOI:
https://doi.org/10.34119/bjhrv6n2-163Keywords:
gliomas, anticoagulação, hemorragiaAbstract
INTRODUÇÃO: a população mundial vem apesentando uma melhora na expectativa de vida e associado a este fato está um aumento na prevalência dos tumores em geral, principalmente os cerebrais. Os pacientes com câncer têm maior possibilidade de eventos trombóticos, mas como existe um receio de anticoagular estes pacientes devido à possibilidade de sangramento maciço intracraniano. OBJETIVOS: Avaliar a segurança do anticoagulante em pacientes com eventos trombóticos e submetidos a cirurgia para gliomas de alto grau. MÉTODOS: foi realizado uma pesquisa no PUBMED com as seguintes palavras: “glioma” e “hemorrhage” e “coagulation” não colocando qualquer filtro. Após ler atentamente os artigos, fazendo uso dos critérios de inclusão e exclusão, procedeu-se a análise estatística. RESULTADOS: Foram selecionados 30 artigos, mas somente dois foram avaliados. O total de pacientes nos dois artigos era de 669 pacientes portadores de gliomas de alto grau, sendo 523 no primeiro artigo e 146 no segundo; 120 pacientes foram anticoagulados e somente 17 (14,1%) tiveram hemorragia intracraniana. CONCLUSÃO: tendo em vista os resultados apresentados nesta pesquisa, o uso de anticoagulantes é seguro para o tratamento de eventos trombóticos em pacientes submetidos a cirurgia de gliomas de alto grau.
References
BLANN AD, LIP GY. Virchow ́s triad revisited: The importance of soluble coagulation factors, the endotelium and platelets. Thromb Res. 2001;101(4):323-27.
CHAICHANA KL, PENDLETON C, JACKSON C et al. Deep venous thrombosis and pulmonar embolisms in adult patients undergoing craniotomy for brain tumors. Neurol Res 2013;35(2):206-211
CARDEN CP, LARKIN JM, ROSENTHAL MA. What is the risk of intracranial bleeding during anti-VEGF therapy? Neuro Oncol 2008;10(4):624-630).
COMELLI I, LIPPI G, CAMPANA V, SERVADEI F, CERVELLIN G. Clinical presentation and epidemiology of brain tumors firstly diagnosed in adults in the Emergency Department: a 10-year, single center retrospective study. Ann Transl Med 2017;5(13):269. doi: 10.21037/atm.2017.06.12.
CONNORS JM. Testing and monitoring direct oral anticoagulants. Blood. 2018 Nov 08;132(19):2009-2015.
CROCETTI E, TRAMA A, STILLER C, et al. Epidemiology of glial and non-glial brain tumors in Europe. Eur J Cancer. 2012;48(10):1532-1542.
DANO K, BEHRENDT N, HEYER-HANSEN G, JOHNSEN M, LUND LR, PLOUG M, et al. Plasminogen activation and cancer. Thromb Haemost. 2005;93(4):676-81.
DOLECEK TA, PROPP JM, STROUP NE, KRUCHKO C. CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2005-2009. Neuro-oncol 2012;14(Suppl 5):v1-v49).
DONATO J, CAMPIGOTTO F, UHLMANN EJ et al. Intracranial hemorrhage in patients with brain metastases treated with therapeutic enoxaparin: a matched cohort study. Blood 2015;126:494-499.
FRANCO RF. Overview of coagulation, anticoagulation and fibrinolysis. Medicina Ribeirão Preto 2001;34:229-237
FULLER CE, JONES DT, KIERAN MW. New classification for central nervous system tumors: implications for diagnosis and therapy. ASCO educational book 2017;753-763.
JENKINS RB, BLAIR H, BALLMAN KV et al. A t + (1;19)(q10;p10) mediates the combined deletions of 1p and 19q and predicts a better prognosis of patients with oligodendroglioma. Cancer Res 2006; 66: 9852–9861.
JO JT, SCHIFF D, PERRY JR. Thrombosis in brain tumors. Semin Thromb Hemost 2014;40;325-331
HARTMANN C, HENTSCHEL B, WICK W et al. Patients with IDH1 wild type anaplastic astrocytomas exhibit worse prognosis than IDH1-mutated glioblastomas, and IDH1 mutation status accounts for the unfavorable prognostic effect of higher age: implications for classification of gliomas. Acta Neuropathol 2010; 120: 707–718.
IMBERTI D, BECATTINI C, BERNARDI E, CAMPORESE G, CUCCIA C, DENTALI F, PARETTI D. Multidisciplinary approach to the management of patients with pulmonary embolism and deep vein thrombosis: a consensus on diagnosis, traditional therapy and therapy with rivaroxaban. Intern Emerg Med. 2018 Oct;13(7):1037-1049
GALE AJ, GORDON SG. Update on tumor cell pro coagulant factors. Acta Haematol. 2001;106(1-2):25-32.
GEERTS WH, BERGQVIST D, PINEO GF et al. American College of Chest Physicians. Prevention of venous thromboembolism: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 2008;133 (Suppl 6):381-453).
HARDER EM, DESAI O, MARSHALL PS. Clinical Probability Tools for Deep Venous Thrombosis, Pulmonary Embolism, and Bleeding. Clin. Chest Med. 2018 Sep;39(3):473-482.
HILLEN HE. Thrombosis in cancer patients. Ann Oncol. 2001;11(suppl 3):273-276).
HOFFMAN R, HAIM N, BRENNER B. Cancer and thrombosis revisited. Blood Rev. 2001;15(2):61-67
HYLEK EM, SINGER DE. Risk factors for intracerebral hemorrhage in outpatients taking warfarin. Ann Intern Med 1994;120:897-902
JAAKKOLA S, KIVINIEMI TO, AIRAKSINEN KEJ. Cardioversion for atrial fibrillation - how to prevent thromboembolic complications? Ann. Med. 2018 Nov;50(7):549-555.
KANG Y, CHOI SH, KIM YJ, et al. Gliomas: histogram analysis of apparent diffusion coefficient maps with standard- or high-b-value diffusion-weighted MR imaging–correlation with tumor grade. Radiology 2011;261:88290.
KERKHOF M, VECHT CJ. Seizure characteristics and prognostic factors of gliomas. Epilepsia 2013;54(Suppl 9):12-17).
KNOVICH MA, LESSER GJ. The management of thromboembolic disease in patients with central nervous system malignances. Current Treat Options Oncol 2004;5:511-7.
KHOURY MN, MISSIOS S, EDWIN N et al., Intracranial hemorrhage in setting of glioblastoma with venous thromboembolism. Neuro Oncol Pract 2015;2(2):87-96,.
KROS JM, GORLIA T, KOUWENHOVEN MC et al. Panel review of anaplastic oligodendroglioma from European Organization for Research and Treatment of Cancer Trial 26951: assessment of consensus in diagnosis, influence of 1p/19q loss, and correlations with outcome. J Neuropathol Exp Neurol 2007; 66: 545–551).
LACROIX M, ABI-SAID D, FOURNEY DR, et al. A multivariate analysis of 416 patients with glioblastoma multiforme: prognosis, extent of resection, and survival. J Neurosurg 2001;95(2):190-198
LEE AI, LEVINE MN, BAKER RI et al. Low-molecular-weight heparin versus a coumarin for the prevention of recurrent thromboembolism in patients with cancer. N Engl J Med. 2003;349(2):146-153.
LEE YY, VAN TASSEL P. Intracranial oligodendrogliomas: imaging findings in 35 untreated cases. AJR Am J Roentgenol. 1989;152(2):361-369.
LOUIS DN, OHGAKI H, WIESTLER O et al. WHO Classification of Tumours of the Central Nervous System, 4th Edn. Lyon: International Agency for Research on Cancer 2007).
LOUIS DN, PERRY A, REIFENBERGER G, VON DEIMILING A, FIGARELLA-BRANGER D, CAVENEE WK, OHGAKI H, WIESTLER OD, KLEIHEUS P, ELLISON DW. The 2016 world health organization classification of tumors of the central nervous system: a summary. Acta Neuropathol 2016. DOI 10.1007/S00401-01601545-1.
MAGNUS N, D’ASTI E, GARNIER D. et al. Brain neoplasms and coagulation. Semin. Thrombosis Hemost 2013;39:881-895
MANTIA C, UHLMANN EJ, PULIGANDLA M, WEBER GM, NEUBERG D, ZWICKER JI. Predicting the higher rate of intracranial hemorrhage in glioma patients receiving therapeutic enoxaparin. Blood 2017;129(25):3379-3385.
MEGREN MA, WIT CD, QAHTANI MA, GAL GL, CARRIER M. Management of venous thromboembolism in patients with glioma. Thromb Res 2017;105-108.
NGHIEMPHU PL, GREEN RM, POPE WB et al. Safety of anticoagulation use and bevacizumab in patients with glioma. Neuro Oncol 2008;10:355-60
NGUYEN T, ABREY L. Intracranial hemorrhage in patients treated with bevacizumab and low-molecular weight heparina. Clin Adv Hematol Oncol. 2007,5:378-379
OSTROM QT, GITTLEMAN H, FARAH P, et al. CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2006–2010. Neuro-oncol. 2013;15(sup 6): ii1 – 56.
OSTROM QT, BOUCHET L, DAVIS FG, et al. The epidemiology of glioma in adults: a “state of the science” review. Neuro-Oncology 2014;1697):896-913.
PAN E, TSAI JS, MITCHELL SB. Retrospective study of venous thromboembolic and intracerebral hemorrhagic events in glioblastoma patients. Anticancer Res 2009;29:4309-4314.
PERRY JR. Thromboembolic disease in patients with high grade glioma. Neuro Oncol 2012;4:73-80.
POPE WB, LAI A, NGHUEMPBU P et al. MRI in patients with high grade gliomas treated with bevacizumab and chemotherapy. Neurology. 2006;66:1258-1260
PREUSSER M, DE RIBAUPIERRE S, WOHRER A et al. Current concepts and management of glioblastoma. Ann Neurol 2011;70:9-21
RAJA R, SINHA N, SAINI J, et al. Assessment of tissue heterogeneity using diffusion tensor and diffusion kurtosis imaging for grading gliomas. Neuroradiology 2016;58:1217–31.
RUFF RL, POSNER JB. Incidence and treatment of peripheral venous thrombosis in patients with glioma. Ann Neurol 1983;13:344-346.
SARTORI MT, PUPPA AD, BALLIN A et al. Prothrombotic state in glioblastoma multiforme: an evaluation of the procoagulant activity of circulating microparticles. J Neuro Oncol 2011;104:225-231).
SCHUNN C, SCHUNN GB, HOBBS G et al. Inferior vena cava filter placement in late-stage cancer. Vasc Endovasc Surg 2006;40:287-94
SIMANEK R, VORMITTAG R. HASSLER M et al. Venous thromboembolism and survival in patients with high-grade glioma. Neuro Oncol 2007;9:89-95
SPYRONPOULOS AC, BROTMAN DJ, AMIN NA et al. Prevention of venous thromboembolism in the cancer surgery patient. Cleve Clin J Med 2008;3(Supplem 3):17-26.
STUPP R. BRADA M, VAN DEN BENT MJ et al. High-grade glioma: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Annals of Oncology;2014;(suppl 3): doi:10.1093/annonc/mdu050.
STURM D, WITT H, HOVESTADT V et al. Hotspot mutations in H3F3A and IDH1 define distinct epigenetic and biological subgroups of glioblastoma. Cancer Cell 2012; 22: 425–437.
WAKAI S, YAMAKAWA S, TAKAHURA K. Spontaneous intracranial hemorrhage caused by brain tumor: its incidence and clinical significance. Neurosurgery 1982;10:437-444.
WEN PY, SCHIFF D, KESARI S et al. Medical management of patients with brain tumors. J Neurooncol 2006;80:313-32
YUST-KATZ S, MANDEL JJ, WU J et al. Venous thromboembolism (VTE) and glioblastoma. J Neurooncol 2015;124:87-94).
ZWICKER JI, KARP LEAF R, CARRIER M. A meta-analysis of intracranial hemorrhage in patients with brain tumors receiving therapeutic anticoagulation. J Thromb Hameost 2016;14(9):1736-1740.
