Photo Credit: Richard Villalon

Regardless of anticoagulation use, patients with cancer are at high risk for clinically relevant bleeding (CRB), according to a study in Blood. Cihan Ay, MD, and colleagues investigated bleeding event prognosis in 791 patients with cancer who initiated systemic anticancer therapies in the Vienna Cancer, Thrombosis, and Bleeding Study: 48% female, median age 63 years, with various cancer types (65.5% with stage IV). Over a median 19-month follow-up, they observed 194 CRB events in 139 patients: 30.0% tumor-related, 46.0% gastrointestinal, and 5.0% intracerebral. First, CRB and major bleeding 12-month cumulative incidence was 16.6% and 9.1%, respectively, in the whole cohort and 14.4% and 7.0%, respectively, in those without anticoagulation. Lower baseline hemoglobin and albumin were associated with bleeding in patients without anticoagulation. Seven bleeding events were fatal, of which six occurred in patients without anticoagulation. “In patients with cancer, bleeding events represent a frequent complication and are associated with increased mortality,” the study authors stated.