Ambrus JL, Ambrus CM, Pickern J, Soldes S, Bross I. Hematologic changes and thromboembolic complications in neoplastic disease and their relationship to metastasis. J Med. 1975;6:433-458.
Bikdeli B, Madhavan MV, Jimenez D, et al. COVID-19 and thrombotic or thromboembolic disease: implications for prevention, antithrombotic therapy, and follow-up: JACC State-of-the-Art Review. J Am Coll Cardiol. 2020;75:2950-2973.
Byrne M, Reynolds JV, O'Donnell JS, et al. Long-term activation of the pro-coagulant response after neoadjuvant chemoradiation and major cancer surgery. Br J Cancer. 2010;102:73-79.
COVIDSurg Collaborative. Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study. Lancet. 2020;396:27-38.
Dai M, Liu D, Liu M, et al. Patients with cancer appear more vulnerable to SARS-CoV-2: a multicenter study during the COVID-19 outbreak. Cancer Discov. 2020;10:783-791.
Docherty AB, Harrison EM, Green CA, et al. Features of 20 133 UK patients in hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: prospective observational cohort study. BMJ. 2020;369:m1985.
Elalamy I, Mahé I, Ageno W, Meyer G. Long-term treatment of cancer-associated thrombosis: the choice of the optimal anticoagulant. J Thromb Haemost. 2017;15:848-857.
Fauvel C, Weizman O, Trimaille A, et al. Pulmonary embolism in COVID-19 patients: a French multicentre cohort study. Eur Heart J. 2020;41:3058-3068.
Frere C, Debourdeau P, Hij A, et al. Therapy for cancer-related thromboembolism. Semin Oncol. 2014;41(3):319-338 [published correction appears in Semin Oncol. 2014;41;e47].
Heit JA, Silverstein MD, Mohr DN, Petterson TM, O'Fallon WM, Melton LJ 3rd. Risk factors for deep vein thrombosis and pulmonary embolism: a population-based case-control study. Arch Intern Med. 2000;160:809-815.
Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497-506.
Key NS, Khorana AA, Kuderer NM, et al. Venous thromboembolism prophylaxis and treatment in patients with cancer: ASCO Clinical Practice Guideline Update. J Clin Oncol. 2020;38:496-520.
Khider L, Gendron N, Goudot G, et al. Curative anticoagulation prevents endothelial lesion in COVID-19 patients. J Thromb Haemost. 2020;10.1111/jth.14968.
Klil-Drori AJ, Yin H, Tagalakis V, Aprikian A, Azoulay L. Androgen deprivation therapy for prostate cancer and the risk of venous thromboembolism. Eur Urol. 2016;70:56-61.
Lee LY, Cazier JB, Angelis V, et al. COVID-19 mortality in patients with cancer on chemotherapy or other anticancer treatments: a prospective cohort study. Lancet. 2020;395:1919-1926.
Leebeek FW. Update of thrombosis in multiple myeloma. Thromb Res. 2016;140(Suppl 1):S76-S80.
McGonagle D, O'Donnell JS, Sharif K, Emery P, Bridgewood C. Immune mechanisms of pulmonary intravascular coagulopathy in COVID-19 pneumonia. Lancet Rheumatol. 2020;2:e437-e445.
McGonagle D, Sharif K, O'Regan A, Bridgewood C. The Role of cytokines including interleukin-6 in COVID-19 induced pneumonia and macrophage activation syndrome-like disease. Autoimmun Rev. 2020;19:102537.
Nadkarni GN, Lala A, Bagiella E, et al. Anticoagulation, mortality, bleeding and pathology among patients hospitalized with COVID-19: a single health system study. J Am Coll Cardiol. 2020;S0735-1097(20)36408-1.
National Institutes of Health. NIH COVID-19 Treatment Guidelines. Management of persons with COVID-19. Last updated June 11, 2020.
Oppelt P, Betbadal A, Nayak L. Approach to chemotherapy-associated thrombosis. Vasc Med. 2015;20:153-161.
O'Sullivan JM, Gonagle DM, Ward SE, Preston RJS, O'Donnell JS. Endothelial cells orchestrate COVID-19 coagulopathy. Lancet Haematol. 2020;7:e553-e555.
Petersen LJ. Anticoagulation therapy for prevention and treatment of venous thromboembolic events in cancer patients: a review of current guidelines. Cancer Treat Rev. 2009;35:754-764.
Pfrepper C. Paraneoplastic thromboembolism and thrombophilia: significance in visceral medicine. Visc Med. 2020;36:280-287.
Seng S, Liu Z, Chiu SK, et al. Risk of venous thromboembolism in patients with cancer treated with cisplatin: a systematic review and meta-analysis. J Clin Oncol. 2012;30:4416-4426.
Spyropoulos AC, Levy JH, Ageno W, et al. Scientific and Standardization Committee communication: Clinical guidance on the diagnosis, prevention, and treatment of venous thromboembolism in hospitalized patients with COVID-19. J Thromb Haemost. 2020;18:1859-1865.
Susen S, Tacquard CA, Godon A, et al. Prevention of thrombotic risk in hospitalized patients with COVID-19 and hemostasis monitoring. Crit Care. 2020;24:364.
Varga Z, Flammer AJ, Steiger P, et al. Endothelial cell infection and endotheliitis in COVID-19. Lancet. 2020;395:1417-1418.
Walker AJ, West J, Card TR, Crooks C, Kirwan CC, Grainge MJ. When are breast cancer patients at highest risk of venous thromboembolism? A cohort study using English health care data. Blood. 2016;127:849-953.
WHO website. Accessed October 7, 2020. https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020
Wichmann D, Sperhake JP, Lütgehetmann M, et al. Autopsy findings and venous thromboembolism in patients with COVID-19: a prospective cohort study. Ann Intern Med. 2020;173268-277.
Worldometers.info website. Accessed October 7, 2020. https://www.worldometers.info/coronavirus/
Wun T, White RH. Epidemiology of cancer-related venous thromboembolism. Best Pract Res Clin Haematol. 2009;22:9-23.

WebMD Global requires each individual who is in a position to control the content of one of its educational activities to disclose any relevant financial relationships occurring within the past 12 months that could create a conflict of interest.

Faculty

Florian Lordick, MD, PhD

Professor
University Cancer Center Leipzig (UCCL)
University Medicine
Leipzig, Germany

Disclosures

Disclosure: Florian Lordick, MD, PhD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Amgen; Astellas; Biontech; Bristol Myers Squibb; Eli Lilly and Company; Merck Sharp & Dohme; Roche; Servier; Zymeworks
Served as a speaker or a member of a speakers bureau for: Amgen; AstraZeneca; Bristol Myers Squibb; Eli Lilly and Company; Elsevier; Infomedica; Medtalks Switzerland; MedUpdate; Merck; Merck Sharp & Dohme; Promedicis; Roche; Servier; Springer; STreamUp!
Received grants for clinical research from: Bristol Myers Squibb

Anna Falanga, MD

Professor of Hematology
University of Milan Bicocca, School of Medicine
Chief
Department of Immunohematology and Transfusion Medicine, Thrombosis and Hemostasis Center,
Hospital Papa Giovanni XXIII
Bergamo, Italy

Disclosures

Disclosure: Anna Falanga, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Bayer; Pfizer; Sanofi

James S. O'Donnell, MB, PhD, FRCPI, FRCPath

Professor of Vascular Biology
Director of Irish Centre for Vascular Biology
Royal College of Surgeons in Ireland
Consultant Haematologist
National Coagulation Centre
St James' Hospital
Dublin, Ireland

Disclosures

Disclosure: James S. O’Donnell, MB, PhD, FRCPI, FRCPath, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Baxter; Bayer; Bristol Myers Squibb; CSL Behring; Daiichi Sankyo; Octapharma; Pfizer; Shire; Sobi Biogen; Takeda
Served as a speaker or a member of a speakers bureau for: Baxter; Bayer; Bristol Myers Squibb; Leo Pharma; Novo Nordisk; Octapharma; Pfizer; Roche; Shire; Sobi Biogen; Takeda
Received grants for clinical research from: Baxalta; Baxter; Bayer; Novo Nordisk; Pfizer; Shire; Takeda

David Smadja, MD, PhD

Hematology Department
Inserm UMR-S 1140 (Team 1)
Director of Biosurgical Research Lab (Carpentier Foundation)
Paris Descartes University and European Georges Pompidou Hospital
Paris, France

Disclosures

Disclosure: David Smadja, MD, PhD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Carmat; Leo Pharma
Served as a speaker or a member of a speakers bureau for: Bayer; Bristol Myers Squibb

Editor

Walid Amara, MD

Medical Education Director, WebMD Global, LLC

Disclosures

Disclosure: Walid Amara, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: BIOTRONIK; Servier
Served as a speaker or a member of a speakers bureau for: Amgen, Bayer HealthCare Pharmaceuticals; Boehringer Ingelheim Pharmaceuticals, Inc.; Boston Scientific; Bristol-Myers Squibb Company; Daiichi Sankyo, Inc.; Livanova; MEDA; Medtronic, Inc.; MSD; Novartis; Pfizer Inc.; Physiomed; St. Jude, Servier

CME Reviewer

Robert Morris, PharmD

Associate Director, Accreditation and Compliance, Medscape, LLC

Disclosures

Disclosure: Robert Morris, PharmD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: ViiV Healthcare
Owns stock, stock options, or bonds from: GlaxoSmithKline

CPD

COVID 19, thrombosis, inflammation and cancer: Lessons Learned and Future Practice

Authors: Florian Lordick, MD, PhD; Anna Falanga, MD; James S. O'Donnell, MB, PhD, FRCPI, FRCPath; David Smadja, MD, PhD
CPD Released: 11/13/2020
THIS ACTIVITY HAS EXPIRED FOR CREDIT
Valid for credit through: 11/13/2021, 11:59 PM EST

Start Activity

Target Audience and Goal Statement

This educational activity is intended for an international audience of non-US hematology/oncology specialists, critical care specialists, and cardiologists.

The goal of this activity is to increase knowledge on the role of thrombosis and inflammation in patients with COVID-19 and implications to managing these patients, including those with cancer.

Upon completion of this activity, participants will:

Have increased knowledge regarding the
- Impact of COVID-19 on coagulation
- Role of thrombosis on outcomes in patients with COVID-19
Have greater competence related to
- Management of thrombosis in patients with COVID-19, including patients with cancer

Disclosures

Faculty

Florian Lordick, MD, PhD

Professor
University Cancer Center Leipzig (UCCL)
University Medicine
Leipzig, Germany

Disclosures

Disclosure: Florian Lordick, MD, PhD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Amgen; Astellas; Biontech; Bristol Myers Squibb; Eli Lilly and Company; Merck Sharp & Dohme; Roche; Servier; Zymeworks
Served as a speaker or a member of a speakers bureau for: Amgen; AstraZeneca; Bristol Myers Squibb; Eli Lilly and Company; Elsevier; Infomedica; Medtalks Switzerland; MedUpdate; Merck; Merck Sharp & Dohme; Promedicis; Roche; Servier; Springer; STreamUp!
Received grants for clinical research from: Bristol Myers Squibb

Anna Falanga, MD

Professor of Hematology
University of Milan Bicocca, School of Medicine
Chief
Department of Immunohematology and Transfusion Medicine, Thrombosis and Hemostasis Center,
Hospital Papa Giovanni XXIII
Bergamo, Italy

Disclosures

Disclosure: Anna Falanga, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Bayer; Pfizer; Sanofi

James S. O'Donnell, MB, PhD, FRCPI, FRCPath

Professor of Vascular Biology
Director of Irish Centre for Vascular Biology
Royal College of Surgeons in Ireland
Consultant Haematologist
National Coagulation Centre
St James' Hospital
Dublin, Ireland

Disclosures

Disclosure: James S. O’Donnell, MB, PhD, FRCPI, FRCPath, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Baxter; Bayer; Bristol Myers Squibb; CSL Behring; Daiichi Sankyo; Octapharma; Pfizer; Shire; Sobi Biogen; Takeda
Served as a speaker or a member of a speakers bureau for: Baxter; Bayer; Bristol Myers Squibb; Leo Pharma; Novo Nordisk; Octapharma; Pfizer; Roche; Shire; Sobi Biogen; Takeda
Received grants for clinical research from: Baxalta; Baxter; Bayer; Novo Nordisk; Pfizer; Shire; Takeda

David Smadja, MD, PhD

Hematology Department
Inserm UMR-S 1140 (Team 1)
Director of Biosurgical Research Lab (Carpentier Foundation)
Paris Descartes University and European Georges Pompidou Hospital
Paris, France

Disclosures

Disclosure: David Smadja, MD, PhD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Carmat; Leo Pharma
Served as a speaker or a member of a speakers bureau for: Bayer; Bristol Myers Squibb

Editor

Walid Amara, MD

Medical Education Director, WebMD Global, LLC

Disclosures

Disclosure: Walid Amara, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: BIOTRONIK; Servier
Served as a speaker or a member of a speakers bureau for: Amgen, Bayer HealthCare Pharmaceuticals; Boehringer Ingelheim Pharmaceuticals, Inc.; Boston Scientific; Bristol-Myers Squibb Company; Daiichi Sankyo, Inc.; Livanova; MEDA; Medtronic, Inc.; MSD; Novartis; Pfizer Inc.; Physiomed; St. Jude, Servier

CME Reviewer

Robert Morris, PharmD

Associate Director, Accreditation and Compliance, Medscape, LLC

Disclosures

Disclosure: Robert Morris, PharmD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: ViiV Healthcare
Owns stock, stock options, or bonds from: GlaxoSmithKline

Accreditation Statements

For Physicians

The Faculty of Pharmaceutical Medicine of the Royal Colleges of Physicians of the United Kingdom (FPM) has reviewed and approved the content of this educational activity and allocated it 0.50 continuing professional development credits (CPD).

Contact WebMD Global

For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity noted above. For technical assistance, contact [email protected]

Instructions for Participation and Credit

There are no fees for participating in or receiving credit for this online educational activity. For information about your eligibility to claim credit, please consult your professional licensing board.

This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent participating in the activity. To successfully earn credit, participants must complete the activity online during the credit eligibility period that is noted on the title page.

Follow these steps to claim a credit certificate for completing this activity:

Read the information provided on the title page regarding the target audience, learning objectives, and author disclosures, read and study the activity content and then complete the post-test questions. If you earn a passing score on the post-test and we have determined based on your registration profile that you may be eligible to claim CPD credit for completing this activity, we will issue you a CPD credit certificate.
Once your CPD credit certificate has been issued, you may view and print the certificate from your CME/CE Tracker. CPD credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period you can print out the tally as well as the certificates by accessing "Edit Your Profile" at the top of the Medscape Education homepage.

We encourage you to complete an Activity Evaluation to provide feedback for future programming.

You may now view or print the certificate from your CME/CE Tracker. You may print the certificate but you cannot alter it. Credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period you can print out the tally as well as the certificates by accessing "Edit Your Profile" at the top of your Medscape homepage.

*The credit that you receive is based on your user profile.

From Medscape Education

CPD

COVID 19, thrombosis, inflammation and cancer: Lessons Learned and Future Practice

Authors: Florian Lordick, MD, PhD; Anna Falanga, MD; James S. O'Donnell, MB, PhD, FRCPI, FRCPath; David Smadja, MD, PhDFaculty and Disclosures

THIS ACTIVITY HAS EXPIRED FOR CREDIT

CPD Released: 11/13/2020

Valid for credit through: 11/13/2021, 11:59 PM EST

processing....

ACE = angiotensin-converting enzyme
aPTT = activated partial thromboplastin time
AUC = area under the curve
bid = twice daily
BMI = body mass index
CI = confidence interval
CV = cardiovascular
DIC = disseminated intravascular coagulation
DOAC = direct oral anticoagulant
DVT = deep vein thrombosis
EC = endothelial cell
ECMO = extracorporeal membrane oxygenation
F = factor
G-CSF = granulocyte colony-stimulating factor
HR = hazard ratio
ICU = intensive care unit
IFN = interferon
IL = interleukin
Hs-cTnI = high-sensitivity cardiac troponin
LMWH = low-molecular-weight heparin
MCP1 = monocyte chemoattractant protein-1
OR = odds ratio
PaO2/FiO2 = ratio of arterial partial pressure of oxygen to fraction of inspired oxygen
PAI = plasminogen activator inhibitor
PCR = polymerase chain reaction
PIC = pulmonary intravascular coagulation
po = by mouth
PT = prothrombin time
qd = once daily
ROC = receiver operating characteristics
RV = right ventricular
SpO2 = saturation of oxygen
sq = subcutaneous
tid = three times daily
TF = tissue factor
TM = thrombomodulin
TNF = tumor necrosis factor
tPA = tissue plasminogen activator
UFH = unfractionated heparin
uPA = urokinase-type plasminogen activator
uPAR = urokinase-type plasminogen activator receptor
VEGF = vascular endothelial growth factor
VTE = venous thromboembolism

« Return to: COVID 19, thrombosis, inflammation and cancer: Lessons Learned and Future Practice

References

Faculty and Disclosures

Faculty

Florian Lordick, MD, PhD

Anna Falanga, MD

James S. O'Donnell, MB, PhD, FRCPI, FRCPath

David Smadja, MD, PhD

Editor

Walid Amara, MD

CME Reviewer

Robert Morris, PharmD

CPD

COVID 19, thrombosis, inflammation and cancer: Lessons Learned and Future Practice

Target Audience and Goal Statement

Disclosures

Faculty

Florian Lordick, MD, PhD

Anna Falanga, MD

James S. O'Donnell, MB, PhD, FRCPI, FRCPath

David Smadja, MD, PhD

Editor

Walid Amara, MD

CME Reviewer

Robert Morris, PharmD

Accreditation Statements

For Physicians

Instructions for Participation and Credit

COVID 19, thrombosis, inflammation and cancer: Lessons Learned and Future Practice

Expert Commentary