2146P Cancer-associated thrombosis clinic: Experience of the Medical Oncology Department of a hospital in Spain

Venous thromboembolism (VTE) in cancer patients is a common complication that requires a multidisciplinary management. In April 2021 we established in the Medical Oncology Department of our hospital a “Cancer-associated thrombosis (CAT) clinic” in order to provide immediate support in prevention and management of VTE to physicians involved in cancer patients’ treatment. The aim of this analysis is to describe the characteristics of patients evaluated, the decisions taken and their results. Between May 2021 and April 2023, 124 patients have been evaluated in the “CAT clinic” of the Medical Oncology Department of the Hospital General Universitario Gregorio Marañón (Madrid, Spain) with a mean follow-up of 4.25 months (standard deviation +/- 5.47 months). The main reason for referral to clinic was VTE treatment (n=120; 96.8%) and the most frequent thrombotic event was pulmonary thromboembolism (n=56; 46.7%). The most common tumors were breast (n=29; 23.4%), lung (n=21; 16.9%) and colon cancer (n=16; 12.9%). Most patients had metastatic disease (n=85; 72.0%), active cancer (n=101; 81.5%) or are receiving antineoplastic therapies (n=95; 76.6%). A modification of anticoagulation therapy was conducted in 99 patients (80.5%): change of anticoagulant drug in 77 patients (most of them from low molecular weight heparins to direct-acting oral anticoagulants [n=51;66.2%]) or change of anticoagulant dose in 49 patients (most of them from therapeutic dose to prophylactic dose in patients with low risk of recurrence and/or high risk of bleeding [n=27;55.1%]). Recurrence of VTE was observed in 8 patients (6.7%) and major bleeding (MB) in 4 patients (3.3%). In particular, 63 patients (52.5%) have received or are receiving apixaban for VTE treatment. No differences were observed between patients receiving apixaban and general population in tumor type, stage, antineoplastic treatment, or thrombotic event. VTE recurrence was seen in 2 patients (3.2%) and MB in 1 patient (1.6%) during apixaban treatment. The “CAT clinic” has allowed us to adapt the anticoagulant treatment in most of patients, obtaining low complication rates (recurrence/bleeding).