Study Of Weight-Based Versus Standard Dose Enoxaparin Thromboprophylaxis In High-Risk Hospitalized Cancer Patients

Inclusion Criteria:

• Participants must have histologically or cytologically confirmed diagnosis of solid tumor malignancy, lymphoma or multiple myeloma.
• Cancer diagnosis or received treatment (chemotherapy or radiotherapy) for malignancy within the previous 6 months

• One or more Padua-based risk factor:

  • History of previous venous thromboembolic event (excluding superficial vein thrombosis)
  • Reduced mobility (ECOG performance status 3 or 4, see Appendix A)
  • Established hereditary thrombophilia (e.g. Factor V Leiden, G20210 prothrombin mutation, protein C or S deficiency, antithrombin deficiency).
  • Recent surgery within the last 30 days
  • Age ≥ 70 years
  • Congestive heart failure (NYHA class III or IV)
  • Complicated respiratory insufficiency (defined as an increased requirement for supplementary oxygen of at least 2L)
  • Acute myocardial infarction or ischemic stroke
  • Obesity (BMI ≥ 30)
  • Receiving hormonal agents (e.g. tamoxifen, estrogen, testosterone)
  • Acute infection (i.e. requiring antimicrobial therapy)
• Age ≥ 18 years
• Life expectancy of greater than 30 days
• Platelet count ≥ 100,000/mcL
• Creatinine < 1.5 mg/dL or estimated creatinine clearance ≥ 50 mL/min/1.73 m2
• Ability to understand and the willingness to sign a written informed consent document
• Weight between 50kg to 130 kg.

Exclusion Criteria:

• History of allergic reactions attributed to heparin or low molecular weight heparin
• Active bleeding or otherwise considered high risk for hemorrhage (e.g. known acute gastrointestinal ulcer)
• Any history of significant hemorrhage (requiring hospitalization or transfusion) within the last 6 months (excluding hemorrhage during operative procedure).
• History of heparin induced Thrombocytopenia
• Presence of coagulopathy (PT or PTT> 1.2 x upper limit of normal)
• Known diagnosis of disseminated intravascular coagulation
• Currently receiving therapeutic anticoagulant therapy or dual antiplatelet therapy (eg. aspirin and clopidogrel)
• Uncontrolled arterial hypertension (systolic blood pressure > 200mmHg, diastolic >110mmHg)
• Active peptic ulcer disease
• Bacterial Endocardititis
• Received any type of Pharmacologic Thromboprophylaxis (e.g. low molecular weight heparin or heparin) for >48 hours during current hospitalization
• Known brain metastases