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document
Anti-Xa effect of a low molecular weight heparin ( dalteparin ) does not accumulate in extended duration therapy for venous thromboembolism in cancer patients . Many patients with venous thromboembolism are being treated with low molecular weight heparin for extended periods of time . It is not certain if it is necessary to assess anti-Xa levels for extended treatment periods . This study is a prospective assessment of anti-Xa levels in patients on long-term therapy for acute venous thromboembolism who have active cancer . Consecutive consenting patients from one center in a multicenter trial that compared 6 months of low molecular weight heparin with oral anticoagulant therapy were treated with therapeutic doses of dalteparin ( 200 IU per kilogram ) subcutaneously daily . Anti-Xa levels were assessed at the end of weeks 1 and 4,4-6 hours after injection of dalteparin . Patients were followed for bleeding and recurrent venous thromboembolism . There were 24 patients who had anti-Xa levels measured at weeks 1 and 4 . Two other patients had week 1 measurements performed but died before the week 4 sample was collected due to their underlying cancer . The mean anti-Xa levels at weeks 1 and 4 were 1.11 and 1.03 anti-Xa units/ml respectively ( P=0.13 ) . These results suggest that for patients with active cancer receiving extended duration therapy with low molecular weight heparin ( dalteparin ) there is no accumulation of anti-Xa effect over the first month of therapy . Monitoring of anti-Xa levels in this situation is usually not required .
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Intervention_Pharmacological
heparin ( dalteparin )
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Intervention_Pharmacological
oral anticoagulant therapy
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Intervention_Pharmacological
extended duration therapy
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Intervention_Pharmacological
heparin
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Intervention_Pharmacological
dalteparin
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Outcome_Physical
anti-Xa levels
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Outcome_Physical
anti-Xa levels
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Outcome_Physical
Anti-Xa levels
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Outcome_Adverse-effects
bleeding
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Outcome_Physical
recurrent venous thromboembolism
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Outcome_Physical
anti-Xa levels
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Outcome_Mortality
died
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Outcome_Physical
mean anti-Xa levels
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Outcome_Physical
accumulation of anti-Xa effect
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Outcome_Physical
anti-Xa levels
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Participant_Condition
venous thromboembolism
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Participant_Condition
cancer
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Participant_Condition
venous thromboembolism
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Participant_Condition
acute venous thromboembolism
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Participant_Condition
active cancer
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Participant_Sample-size
24 patients
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Participant_Condition
anti-Xa levels
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Participant_Condition
active cancer