Eparine a basso peso molecolare e sopravvivenza in pazienti con cancro. Selezione di casi e revisione della letteratura

Abstract

Thrombo-embolism constitutes a substantial problem in neoplastic patients as it complicates clinical management and worsens the prognosis. Some recent studies have hypothesized a favourable action of low molecular weight heparins (LMWHs) on the survival of these patients. More than once in our institute’s clinical experience we have noticed an improvement in the prognosis and a slowdown in the growth of the tumour in subjects affected by advanced neoplasia in prophylactic treatment with LMWH. We report three cases of patients affected by cholangiocarcinoma, carcinoma of the pancreas and non small cell lung cancer (NSCLC). All three patients had an inoperable disease at diagnosis and, in addition to specific chemotherapy, followed a daily treatment of Enoxaparine 4000 UI. Notwithstanding the advanced stage of the disease, the survival of these patients was superior to the data reported in literature. Two of these patients are still alive and in treatment, respectively 30 and 29 months after diagnosis. Conclusion. It is likely that low molecular weight heparin carries out an antitumour action. It seems to work in a common, not site-specific, way on the progression of neoplasia, that, notwithstanding the different existing theories, has not yet been identified with certainty. The studies conducted up until now are insufficient to express a definite opinion and randomized prospective studies would be necessary for this purpose.