The Experts below are selected from a list of 161538 Experts worldwide ranked by ideXlab platform
J. J. Vredenburgh - One of the best experts on this subject based on the ideXlab platform.
-
Tinzaparin prophylaxis in Brain Tumor patients
Journal of Clinical Oncology, 2007Co-Authors: C. W. Bohlin, D. A. Reardon, A. Desjardins, J. A. Quinn, J. N. Rich, D. A. Bota, K. Goli, H. S. Friedman, J. J. VredenburghAbstract:12506 Background: Thromboembolic disease is the second leading cause of death in Brain Tumor patients. Various studies have documented a 20–40% risk of deep vein thrombosis and / or pulmonary embolus in Brain Tumor patients. When used as prophylaxis, Tinzaparin, a low molecular weight heparin with factor Xa activity, has a low complication rate and low incidence of bleeding complications. With the anticipated benefit exceeding any risk, prophylaxis with Tinzaparin may be safe and effective. Methods: A phase II trial of prophylactic tinzaparin for newly diagnosed Brain Tumor patients has completed accrual at 40 patients. A fixed daily dose of 4500 IU subcutaneous tinzaparin was given beginning a minimum of 48 hours post-operatively and a maximum of 4 weeks post-operatively. Patients consented to take tinzaparin daily for 12 months. Weekly blood counts were monitored during chemotherapy cycles. Tinzaparin was held if platelet count was <50,000 and resumed once the platelets were >100,000. Tinzaparin was discontinued in patients who began treatment with avastin. Results: Of 40 patients, 7 remain on treatment. Patients have taken tinzaparin for 4–52 weeks with a median of 21 weeks. One of the patients developed a grade 3 CNS hemorrhage and one had a grade 1 CNS hemorrhage, necessitating cessation of the tinzaparin, there have been no grade 4 or 5 CNS hemorrhages or treatment associated mortality. No patients developed = grade 2 systemic hemorrhages. One patient developed a deep venous thrombosis while taking tinzaparin, and three patients developed thromboembolic complications while off tinzaparin secondary to thrombocytopenia. One patient was taken off study for increased liver function tests, possibly secondary to tinzaparin. Conclusions: Thus far, daily prophylactic tinzaparin has proven safe and effective in decreasing the incidence of thromboembolic disease in Brain Tumor patients. We plan a phase III study upon the safe completion of the last 7 patients on this phase II study. No significant financial relationships to disclose.
-
tinzaparin prophylaxis in Brain Tumor patients
Journal of Clinical Oncology, 2007Co-Authors: Cindy Bohlin, D. A. Reardon, A. Desjardins, J. A. Quinn, D. A. Bota, K. Goli, H. S. Friedman, Jeremy N. Rich, J. J. VredenburghAbstract:12506 Background: Thromboembolic disease is the second leading cause of death in Brain Tumor patients. Various studies have documented a 20–40% risk of deep vein thrombosis and / or pulmonary embol...
-
Tinzaparin prophylaxis against thromboembolic complications in Brain Tumor patients
Journal of Clinical Oncology, 2006Co-Authors: J. J. Vredenburgh, D. A. Reardon, A. Desjardins, J. A. Quinn, J. N. Rich, Cindy Bohlin, Sith Sathornsumetee, Lawrence B. Marks, A. H. Friedman, H. S. FriedmanAbstract:1539 Background: Thromboembolic complications are common in Brain Tumor patients, contribute to the morbidity and mortality and complicate treatment. Twenty to 40% of Brain Tumor patients develop a deep venous thrombosis and/or pulmonary embolus during their course. Thromboembolic complications are the second leading cause of death in Brain Tumor patients. One of the low molecular weight heparins, tinzaparin, has increased factor Xa activity as opposed to thrombin inhibition, which may improve the therapeutic:toxicity ratio. Methods: We report a phase II trial of prophylactic tinzaparin for newly diagnosed Brain Tumor patients. Twenty-seven of the planned 40 patients have been accrued. Patients received daily tinzaparin at a fixed dose of 4500 IU subcutaneously beginning a minimum of 48 hours post-operatively and a maximum of 4 weeks post-operatively. Patients were scheduled to receive tinzaparin for 12 months. During chemotherapy cycles, the blood counts were monitored weekly. If the platelet count was <50,000, the tinzaparin was held until the platelets were >100,000. Results: One of the patients developed a grade 3 CNS hemorrhage, necessitating cessation of the tinzaparin, there have been no grade 4 or 5 CNS hemorrhages or treatment associated mortality. Also, there have been no ≥ grade 2 systemic hemorrhages. One patient developed a deep venous thrombosis while taking tinzaparin, and three patients developed thromboembolic complications while off tinzaparin secondary to thrombocytopenia. One patient was taken off study for increased liver function tests, possibly secondary to tinzaparin. The patients have taken the tinzaparin for 4–52 weeks, with a median of 18 weeks. Conclusions: Tinzaparin at a fixed prophylactic dose is safe and may decrease the incidence of thromboembolic complications in Brain Tumor patients. If the completed phase II study yields similar results, a phase III trial is warranted. No significant financial relationships to disclose.
-
tinzaparin prophylaxis against thromboembolic complications in Brain Tumor patients
Journal of Clinical Oncology, 2006Co-Authors: J. J. Vredenburgh, D. A. Reardon, A. Desjardins, J. A. Quinn, J. N. Rich, Cindy Bohlin, Sith Sathornsumetee, Lawrence B. Marks, A. H. Friedman, H. S. FriedmanAbstract:1539 Background: Thromboembolic complications are common in Brain Tumor patients, contribute to the morbidity and mortality and complicate treatment. Twenty to 40% of Brain Tumor patients develop a deep venous thrombosis and/or pulmonary embolus during their course. Thromboembolic complications are the second leading cause of death in Brain Tumor patients. One of the low molecular weight heparins, tinzaparin, has increased factor Xa activity as opposed to thrombin inhibition, which may improve the therapeutic:toxicity ratio. Methods: We report a phase II trial of prophylactic tinzaparin for newly diagnosed Brain Tumor patients. Twenty-seven of the planned 40 patients have been accrued. Patients received daily tinzaparin at a fixed dose of 4500 IU subcutaneously beginning a minimum of 48 hours post-operatively and a maximum of 4 weeks post-operatively. Patients were scheduled to receive tinzaparin for 12 months. During chemotherapy cycles, the blood counts were monitored weekly. If the platelet count was <...
H. S. Friedman - One of the best experts on this subject based on the ideXlab platform.
-
Tinzaparin prophylaxis in Brain Tumor patients
Journal of Clinical Oncology, 2007Co-Authors: C. W. Bohlin, D. A. Reardon, A. Desjardins, J. A. Quinn, J. N. Rich, D. A. Bota, K. Goli, H. S. Friedman, J. J. VredenburghAbstract:12506 Background: Thromboembolic disease is the second leading cause of death in Brain Tumor patients. Various studies have documented a 20–40% risk of deep vein thrombosis and / or pulmonary embolus in Brain Tumor patients. When used as prophylaxis, Tinzaparin, a low molecular weight heparin with factor Xa activity, has a low complication rate and low incidence of bleeding complications. With the anticipated benefit exceeding any risk, prophylaxis with Tinzaparin may be safe and effective. Methods: A phase II trial of prophylactic tinzaparin for newly diagnosed Brain Tumor patients has completed accrual at 40 patients. A fixed daily dose of 4500 IU subcutaneous tinzaparin was given beginning a minimum of 48 hours post-operatively and a maximum of 4 weeks post-operatively. Patients consented to take tinzaparin daily for 12 months. Weekly blood counts were monitored during chemotherapy cycles. Tinzaparin was held if platelet count was <50,000 and resumed once the platelets were >100,000. Tinzaparin was discontinued in patients who began treatment with avastin. Results: Of 40 patients, 7 remain on treatment. Patients have taken tinzaparin for 4–52 weeks with a median of 21 weeks. One of the patients developed a grade 3 CNS hemorrhage and one had a grade 1 CNS hemorrhage, necessitating cessation of the tinzaparin, there have been no grade 4 or 5 CNS hemorrhages or treatment associated mortality. No patients developed = grade 2 systemic hemorrhages. One patient developed a deep venous thrombosis while taking tinzaparin, and three patients developed thromboembolic complications while off tinzaparin secondary to thrombocytopenia. One patient was taken off study for increased liver function tests, possibly secondary to tinzaparin. Conclusions: Thus far, daily prophylactic tinzaparin has proven safe and effective in decreasing the incidence of thromboembolic disease in Brain Tumor patients. We plan a phase III study upon the safe completion of the last 7 patients on this phase II study. No significant financial relationships to disclose.
-
tinzaparin prophylaxis in Brain Tumor patients
Journal of Clinical Oncology, 2007Co-Authors: Cindy Bohlin, D. A. Reardon, A. Desjardins, J. A. Quinn, D. A. Bota, K. Goli, H. S. Friedman, Jeremy N. Rich, J. J. VredenburghAbstract:12506 Background: Thromboembolic disease is the second leading cause of death in Brain Tumor patients. Various studies have documented a 20–40% risk of deep vein thrombosis and / or pulmonary embol...
-
Tinzaparin prophylaxis against thromboembolic complications in Brain Tumor patients
Journal of Clinical Oncology, 2006Co-Authors: J. J. Vredenburgh, D. A. Reardon, A. Desjardins, J. A. Quinn, J. N. Rich, Cindy Bohlin, Sith Sathornsumetee, Lawrence B. Marks, A. H. Friedman, H. S. FriedmanAbstract:1539 Background: Thromboembolic complications are common in Brain Tumor patients, contribute to the morbidity and mortality and complicate treatment. Twenty to 40% of Brain Tumor patients develop a deep venous thrombosis and/or pulmonary embolus during their course. Thromboembolic complications are the second leading cause of death in Brain Tumor patients. One of the low molecular weight heparins, tinzaparin, has increased factor Xa activity as opposed to thrombin inhibition, which may improve the therapeutic:toxicity ratio. Methods: We report a phase II trial of prophylactic tinzaparin for newly diagnosed Brain Tumor patients. Twenty-seven of the planned 40 patients have been accrued. Patients received daily tinzaparin at a fixed dose of 4500 IU subcutaneously beginning a minimum of 48 hours post-operatively and a maximum of 4 weeks post-operatively. Patients were scheduled to receive tinzaparin for 12 months. During chemotherapy cycles, the blood counts were monitored weekly. If the platelet count was <50,000, the tinzaparin was held until the platelets were >100,000. Results: One of the patients developed a grade 3 CNS hemorrhage, necessitating cessation of the tinzaparin, there have been no grade 4 or 5 CNS hemorrhages or treatment associated mortality. Also, there have been no ≥ grade 2 systemic hemorrhages. One patient developed a deep venous thrombosis while taking tinzaparin, and three patients developed thromboembolic complications while off tinzaparin secondary to thrombocytopenia. One patient was taken off study for increased liver function tests, possibly secondary to tinzaparin. The patients have taken the tinzaparin for 4–52 weeks, with a median of 18 weeks. Conclusions: Tinzaparin at a fixed prophylactic dose is safe and may decrease the incidence of thromboembolic complications in Brain Tumor patients. If the completed phase II study yields similar results, a phase III trial is warranted. No significant financial relationships to disclose.
-
tinzaparin prophylaxis against thromboembolic complications in Brain Tumor patients
Journal of Clinical Oncology, 2006Co-Authors: J. J. Vredenburgh, D. A. Reardon, A. Desjardins, J. A. Quinn, J. N. Rich, Cindy Bohlin, Sith Sathornsumetee, Lawrence B. Marks, A. H. Friedman, H. S. FriedmanAbstract:1539 Background: Thromboembolic complications are common in Brain Tumor patients, contribute to the morbidity and mortality and complicate treatment. Twenty to 40% of Brain Tumor patients develop a deep venous thrombosis and/or pulmonary embolus during their course. Thromboembolic complications are the second leading cause of death in Brain Tumor patients. One of the low molecular weight heparins, tinzaparin, has increased factor Xa activity as opposed to thrombin inhibition, which may improve the therapeutic:toxicity ratio. Methods: We report a phase II trial of prophylactic tinzaparin for newly diagnosed Brain Tumor patients. Twenty-seven of the planned 40 patients have been accrued. Patients received daily tinzaparin at a fixed dose of 4500 IU subcutaneously beginning a minimum of 48 hours post-operatively and a maximum of 4 weeks post-operatively. Patients were scheduled to receive tinzaparin for 12 months. During chemotherapy cycles, the blood counts were monitored weekly. If the platelet count was <...
J. A. Quinn - One of the best experts on this subject based on the ideXlab platform.
-
Tinzaparin prophylaxis in Brain Tumor patients
Journal of Clinical Oncology, 2007Co-Authors: C. W. Bohlin, D. A. Reardon, A. Desjardins, J. A. Quinn, J. N. Rich, D. A. Bota, K. Goli, H. S. Friedman, J. J. VredenburghAbstract:12506 Background: Thromboembolic disease is the second leading cause of death in Brain Tumor patients. Various studies have documented a 20–40% risk of deep vein thrombosis and / or pulmonary embolus in Brain Tumor patients. When used as prophylaxis, Tinzaparin, a low molecular weight heparin with factor Xa activity, has a low complication rate and low incidence of bleeding complications. With the anticipated benefit exceeding any risk, prophylaxis with Tinzaparin may be safe and effective. Methods: A phase II trial of prophylactic tinzaparin for newly diagnosed Brain Tumor patients has completed accrual at 40 patients. A fixed daily dose of 4500 IU subcutaneous tinzaparin was given beginning a minimum of 48 hours post-operatively and a maximum of 4 weeks post-operatively. Patients consented to take tinzaparin daily for 12 months. Weekly blood counts were monitored during chemotherapy cycles. Tinzaparin was held if platelet count was <50,000 and resumed once the platelets were >100,000. Tinzaparin was discontinued in patients who began treatment with avastin. Results: Of 40 patients, 7 remain on treatment. Patients have taken tinzaparin for 4–52 weeks with a median of 21 weeks. One of the patients developed a grade 3 CNS hemorrhage and one had a grade 1 CNS hemorrhage, necessitating cessation of the tinzaparin, there have been no grade 4 or 5 CNS hemorrhages or treatment associated mortality. No patients developed = grade 2 systemic hemorrhages. One patient developed a deep venous thrombosis while taking tinzaparin, and three patients developed thromboembolic complications while off tinzaparin secondary to thrombocytopenia. One patient was taken off study for increased liver function tests, possibly secondary to tinzaparin. Conclusions: Thus far, daily prophylactic tinzaparin has proven safe and effective in decreasing the incidence of thromboembolic disease in Brain Tumor patients. We plan a phase III study upon the safe completion of the last 7 patients on this phase II study. No significant financial relationships to disclose.
-
tinzaparin prophylaxis in Brain Tumor patients
Journal of Clinical Oncology, 2007Co-Authors: Cindy Bohlin, D. A. Reardon, A. Desjardins, J. A. Quinn, D. A. Bota, K. Goli, H. S. Friedman, Jeremy N. Rich, J. J. VredenburghAbstract:12506 Background: Thromboembolic disease is the second leading cause of death in Brain Tumor patients. Various studies have documented a 20–40% risk of deep vein thrombosis and / or pulmonary embol...
-
Tinzaparin prophylaxis against thromboembolic complications in Brain Tumor patients
Journal of Clinical Oncology, 2006Co-Authors: J. J. Vredenburgh, D. A. Reardon, A. Desjardins, J. A. Quinn, J. N. Rich, Cindy Bohlin, Sith Sathornsumetee, Lawrence B. Marks, A. H. Friedman, H. S. FriedmanAbstract:1539 Background: Thromboembolic complications are common in Brain Tumor patients, contribute to the morbidity and mortality and complicate treatment. Twenty to 40% of Brain Tumor patients develop a deep venous thrombosis and/or pulmonary embolus during their course. Thromboembolic complications are the second leading cause of death in Brain Tumor patients. One of the low molecular weight heparins, tinzaparin, has increased factor Xa activity as opposed to thrombin inhibition, which may improve the therapeutic:toxicity ratio. Methods: We report a phase II trial of prophylactic tinzaparin for newly diagnosed Brain Tumor patients. Twenty-seven of the planned 40 patients have been accrued. Patients received daily tinzaparin at a fixed dose of 4500 IU subcutaneously beginning a minimum of 48 hours post-operatively and a maximum of 4 weeks post-operatively. Patients were scheduled to receive tinzaparin for 12 months. During chemotherapy cycles, the blood counts were monitored weekly. If the platelet count was <50,000, the tinzaparin was held until the platelets were >100,000. Results: One of the patients developed a grade 3 CNS hemorrhage, necessitating cessation of the tinzaparin, there have been no grade 4 or 5 CNS hemorrhages or treatment associated mortality. Also, there have been no ≥ grade 2 systemic hemorrhages. One patient developed a deep venous thrombosis while taking tinzaparin, and three patients developed thromboembolic complications while off tinzaparin secondary to thrombocytopenia. One patient was taken off study for increased liver function tests, possibly secondary to tinzaparin. The patients have taken the tinzaparin for 4–52 weeks, with a median of 18 weeks. Conclusions: Tinzaparin at a fixed prophylactic dose is safe and may decrease the incidence of thromboembolic complications in Brain Tumor patients. If the completed phase II study yields similar results, a phase III trial is warranted. No significant financial relationships to disclose.
-
tinzaparin prophylaxis against thromboembolic complications in Brain Tumor patients
Journal of Clinical Oncology, 2006Co-Authors: J. J. Vredenburgh, D. A. Reardon, A. Desjardins, J. A. Quinn, J. N. Rich, Cindy Bohlin, Sith Sathornsumetee, Lawrence B. Marks, A. H. Friedman, H. S. FriedmanAbstract:1539 Background: Thromboembolic complications are common in Brain Tumor patients, contribute to the morbidity and mortality and complicate treatment. Twenty to 40% of Brain Tumor patients develop a deep venous thrombosis and/or pulmonary embolus during their course. Thromboembolic complications are the second leading cause of death in Brain Tumor patients. One of the low molecular weight heparins, tinzaparin, has increased factor Xa activity as opposed to thrombin inhibition, which may improve the therapeutic:toxicity ratio. Methods: We report a phase II trial of prophylactic tinzaparin for newly diagnosed Brain Tumor patients. Twenty-seven of the planned 40 patients have been accrued. Patients received daily tinzaparin at a fixed dose of 4500 IU subcutaneously beginning a minimum of 48 hours post-operatively and a maximum of 4 weeks post-operatively. Patients were scheduled to receive tinzaparin for 12 months. During chemotherapy cycles, the blood counts were monitored weekly. If the platelet count was <...
A. Desjardins - One of the best experts on this subject based on the ideXlab platform.
-
Tinzaparin prophylaxis in Brain Tumor patients
Journal of Clinical Oncology, 2007Co-Authors: C. W. Bohlin, D. A. Reardon, A. Desjardins, J. A. Quinn, J. N. Rich, D. A. Bota, K. Goli, H. S. Friedman, J. J. VredenburghAbstract:12506 Background: Thromboembolic disease is the second leading cause of death in Brain Tumor patients. Various studies have documented a 20–40% risk of deep vein thrombosis and / or pulmonary embolus in Brain Tumor patients. When used as prophylaxis, Tinzaparin, a low molecular weight heparin with factor Xa activity, has a low complication rate and low incidence of bleeding complications. With the anticipated benefit exceeding any risk, prophylaxis with Tinzaparin may be safe and effective. Methods: A phase II trial of prophylactic tinzaparin for newly diagnosed Brain Tumor patients has completed accrual at 40 patients. A fixed daily dose of 4500 IU subcutaneous tinzaparin was given beginning a minimum of 48 hours post-operatively and a maximum of 4 weeks post-operatively. Patients consented to take tinzaparin daily for 12 months. Weekly blood counts were monitored during chemotherapy cycles. Tinzaparin was held if platelet count was <50,000 and resumed once the platelets were >100,000. Tinzaparin was discontinued in patients who began treatment with avastin. Results: Of 40 patients, 7 remain on treatment. Patients have taken tinzaparin for 4–52 weeks with a median of 21 weeks. One of the patients developed a grade 3 CNS hemorrhage and one had a grade 1 CNS hemorrhage, necessitating cessation of the tinzaparin, there have been no grade 4 or 5 CNS hemorrhages or treatment associated mortality. No patients developed = grade 2 systemic hemorrhages. One patient developed a deep venous thrombosis while taking tinzaparin, and three patients developed thromboembolic complications while off tinzaparin secondary to thrombocytopenia. One patient was taken off study for increased liver function tests, possibly secondary to tinzaparin. Conclusions: Thus far, daily prophylactic tinzaparin has proven safe and effective in decreasing the incidence of thromboembolic disease in Brain Tumor patients. We plan a phase III study upon the safe completion of the last 7 patients on this phase II study. No significant financial relationships to disclose.
-
tinzaparin prophylaxis in Brain Tumor patients
Journal of Clinical Oncology, 2007Co-Authors: Cindy Bohlin, D. A. Reardon, A. Desjardins, J. A. Quinn, D. A. Bota, K. Goli, H. S. Friedman, Jeremy N. Rich, J. J. VredenburghAbstract:12506 Background: Thromboembolic disease is the second leading cause of death in Brain Tumor patients. Various studies have documented a 20–40% risk of deep vein thrombosis and / or pulmonary embol...
-
Tinzaparin prophylaxis against thromboembolic complications in Brain Tumor patients
Journal of Clinical Oncology, 2006Co-Authors: J. J. Vredenburgh, D. A. Reardon, A. Desjardins, J. A. Quinn, J. N. Rich, Cindy Bohlin, Sith Sathornsumetee, Lawrence B. Marks, A. H. Friedman, H. S. FriedmanAbstract:1539 Background: Thromboembolic complications are common in Brain Tumor patients, contribute to the morbidity and mortality and complicate treatment. Twenty to 40% of Brain Tumor patients develop a deep venous thrombosis and/or pulmonary embolus during their course. Thromboembolic complications are the second leading cause of death in Brain Tumor patients. One of the low molecular weight heparins, tinzaparin, has increased factor Xa activity as opposed to thrombin inhibition, which may improve the therapeutic:toxicity ratio. Methods: We report a phase II trial of prophylactic tinzaparin for newly diagnosed Brain Tumor patients. Twenty-seven of the planned 40 patients have been accrued. Patients received daily tinzaparin at a fixed dose of 4500 IU subcutaneously beginning a minimum of 48 hours post-operatively and a maximum of 4 weeks post-operatively. Patients were scheduled to receive tinzaparin for 12 months. During chemotherapy cycles, the blood counts were monitored weekly. If the platelet count was <50,000, the tinzaparin was held until the platelets were >100,000. Results: One of the patients developed a grade 3 CNS hemorrhage, necessitating cessation of the tinzaparin, there have been no grade 4 or 5 CNS hemorrhages or treatment associated mortality. Also, there have been no ≥ grade 2 systemic hemorrhages. One patient developed a deep venous thrombosis while taking tinzaparin, and three patients developed thromboembolic complications while off tinzaparin secondary to thrombocytopenia. One patient was taken off study for increased liver function tests, possibly secondary to tinzaparin. The patients have taken the tinzaparin for 4–52 weeks, with a median of 18 weeks. Conclusions: Tinzaparin at a fixed prophylactic dose is safe and may decrease the incidence of thromboembolic complications in Brain Tumor patients. If the completed phase II study yields similar results, a phase III trial is warranted. No significant financial relationships to disclose.
-
tinzaparin prophylaxis against thromboembolic complications in Brain Tumor patients
Journal of Clinical Oncology, 2006Co-Authors: J. J. Vredenburgh, D. A. Reardon, A. Desjardins, J. A. Quinn, J. N. Rich, Cindy Bohlin, Sith Sathornsumetee, Lawrence B. Marks, A. H. Friedman, H. S. FriedmanAbstract:1539 Background: Thromboembolic complications are common in Brain Tumor patients, contribute to the morbidity and mortality and complicate treatment. Twenty to 40% of Brain Tumor patients develop a deep venous thrombosis and/or pulmonary embolus during their course. Thromboembolic complications are the second leading cause of death in Brain Tumor patients. One of the low molecular weight heparins, tinzaparin, has increased factor Xa activity as opposed to thrombin inhibition, which may improve the therapeutic:toxicity ratio. Methods: We report a phase II trial of prophylactic tinzaparin for newly diagnosed Brain Tumor patients. Twenty-seven of the planned 40 patients have been accrued. Patients received daily tinzaparin at a fixed dose of 4500 IU subcutaneously beginning a minimum of 48 hours post-operatively and a maximum of 4 weeks post-operatively. Patients were scheduled to receive tinzaparin for 12 months. During chemotherapy cycles, the blood counts were monitored weekly. If the platelet count was <...
D. A. Reardon - One of the best experts on this subject based on the ideXlab platform.
-
Tinzaparin prophylaxis in Brain Tumor patients
Journal of Clinical Oncology, 2007Co-Authors: C. W. Bohlin, D. A. Reardon, A. Desjardins, J. A. Quinn, J. N. Rich, D. A. Bota, K. Goli, H. S. Friedman, J. J. VredenburghAbstract:12506 Background: Thromboembolic disease is the second leading cause of death in Brain Tumor patients. Various studies have documented a 20–40% risk of deep vein thrombosis and / or pulmonary embolus in Brain Tumor patients. When used as prophylaxis, Tinzaparin, a low molecular weight heparin with factor Xa activity, has a low complication rate and low incidence of bleeding complications. With the anticipated benefit exceeding any risk, prophylaxis with Tinzaparin may be safe and effective. Methods: A phase II trial of prophylactic tinzaparin for newly diagnosed Brain Tumor patients has completed accrual at 40 patients. A fixed daily dose of 4500 IU subcutaneous tinzaparin was given beginning a minimum of 48 hours post-operatively and a maximum of 4 weeks post-operatively. Patients consented to take tinzaparin daily for 12 months. Weekly blood counts were monitored during chemotherapy cycles. Tinzaparin was held if platelet count was <50,000 and resumed once the platelets were >100,000. Tinzaparin was discontinued in patients who began treatment with avastin. Results: Of 40 patients, 7 remain on treatment. Patients have taken tinzaparin for 4–52 weeks with a median of 21 weeks. One of the patients developed a grade 3 CNS hemorrhage and one had a grade 1 CNS hemorrhage, necessitating cessation of the tinzaparin, there have been no grade 4 or 5 CNS hemorrhages or treatment associated mortality. No patients developed = grade 2 systemic hemorrhages. One patient developed a deep venous thrombosis while taking tinzaparin, and three patients developed thromboembolic complications while off tinzaparin secondary to thrombocytopenia. One patient was taken off study for increased liver function tests, possibly secondary to tinzaparin. Conclusions: Thus far, daily prophylactic tinzaparin has proven safe and effective in decreasing the incidence of thromboembolic disease in Brain Tumor patients. We plan a phase III study upon the safe completion of the last 7 patients on this phase II study. No significant financial relationships to disclose.
-
tinzaparin prophylaxis in Brain Tumor patients
Journal of Clinical Oncology, 2007Co-Authors: Cindy Bohlin, D. A. Reardon, A. Desjardins, J. A. Quinn, D. A. Bota, K. Goli, H. S. Friedman, Jeremy N. Rich, J. J. VredenburghAbstract:12506 Background: Thromboembolic disease is the second leading cause of death in Brain Tumor patients. Various studies have documented a 20–40% risk of deep vein thrombosis and / or pulmonary embol...
-
Tinzaparin prophylaxis against thromboembolic complications in Brain Tumor patients
Journal of Clinical Oncology, 2006Co-Authors: J. J. Vredenburgh, D. A. Reardon, A. Desjardins, J. A. Quinn, J. N. Rich, Cindy Bohlin, Sith Sathornsumetee, Lawrence B. Marks, A. H. Friedman, H. S. FriedmanAbstract:1539 Background: Thromboembolic complications are common in Brain Tumor patients, contribute to the morbidity and mortality and complicate treatment. Twenty to 40% of Brain Tumor patients develop a deep venous thrombosis and/or pulmonary embolus during their course. Thromboembolic complications are the second leading cause of death in Brain Tumor patients. One of the low molecular weight heparins, tinzaparin, has increased factor Xa activity as opposed to thrombin inhibition, which may improve the therapeutic:toxicity ratio. Methods: We report a phase II trial of prophylactic tinzaparin for newly diagnosed Brain Tumor patients. Twenty-seven of the planned 40 patients have been accrued. Patients received daily tinzaparin at a fixed dose of 4500 IU subcutaneously beginning a minimum of 48 hours post-operatively and a maximum of 4 weeks post-operatively. Patients were scheduled to receive tinzaparin for 12 months. During chemotherapy cycles, the blood counts were monitored weekly. If the platelet count was <50,000, the tinzaparin was held until the platelets were >100,000. Results: One of the patients developed a grade 3 CNS hemorrhage, necessitating cessation of the tinzaparin, there have been no grade 4 or 5 CNS hemorrhages or treatment associated mortality. Also, there have been no ≥ grade 2 systemic hemorrhages. One patient developed a deep venous thrombosis while taking tinzaparin, and three patients developed thromboembolic complications while off tinzaparin secondary to thrombocytopenia. One patient was taken off study for increased liver function tests, possibly secondary to tinzaparin. The patients have taken the tinzaparin for 4–52 weeks, with a median of 18 weeks. Conclusions: Tinzaparin at a fixed prophylactic dose is safe and may decrease the incidence of thromboembolic complications in Brain Tumor patients. If the completed phase II study yields similar results, a phase III trial is warranted. No significant financial relationships to disclose.
-
tinzaparin prophylaxis against thromboembolic complications in Brain Tumor patients
Journal of Clinical Oncology, 2006Co-Authors: J. J. Vredenburgh, D. A. Reardon, A. Desjardins, J. A. Quinn, J. N. Rich, Cindy Bohlin, Sith Sathornsumetee, Lawrence B. Marks, A. H. Friedman, H. S. FriedmanAbstract:1539 Background: Thromboembolic complications are common in Brain Tumor patients, contribute to the morbidity and mortality and complicate treatment. Twenty to 40% of Brain Tumor patients develop a deep venous thrombosis and/or pulmonary embolus during their course. Thromboembolic complications are the second leading cause of death in Brain Tumor patients. One of the low molecular weight heparins, tinzaparin, has increased factor Xa activity as opposed to thrombin inhibition, which may improve the therapeutic:toxicity ratio. Methods: We report a phase II trial of prophylactic tinzaparin for newly diagnosed Brain Tumor patients. Twenty-seven of the planned 40 patients have been accrued. Patients received daily tinzaparin at a fixed dose of 4500 IU subcutaneously beginning a minimum of 48 hours post-operatively and a maximum of 4 weeks post-operatively. Patients were scheduled to receive tinzaparin for 12 months. During chemotherapy cycles, the blood counts were monitored weekly. If the platelet count was <...