Venous thromboembolism prophylaxis in hematopoietic stem cell transplantation patients: an international web-based survey of healthcare providers

Excerpt

Thousands of patients undergo hematopoietic stem cell transplant (HSCT) annually worldwide for treatment of hematologic malignancies as well as benign hematologic and immune disorders. We and others have previously shown that despite severe thrombocytopenia and a high incidence of bleeding complications, 3.7–4.5 % of patients undergoing HSCT suffer symptomatic venous thromboembolism (VTE) [1‐5]. Despite the relatively common occurrence of deep venous thrombosis (DVT) and pulmonary embolism (PE), the optimal approach to VTE prophylaxis for patients undergoing HSCT remains undefined. The absence of high-quality evidence, the narrow risk–benefit ratio, and the lack of published guidelines have all contributed to a therapeutic equipoise regarding the utility of VTE prophylaxis in this setting. As a result, we expected that practice patterns would vary significantly at the physician, institution, and country levels. To determine the current spectrum of VTE prevention practices among physicians caring for patients hospitalized for HSCT, we conducted an anonymous web-based survey of members of the American Society of Blood and Marrow Transplantation (ASBMT). …