Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2018

Venous thromboembolism in patients with glioblastoma multiforme at the Royal Hobart Hospital. (#250)

Julia R Dixon-Douglas 1 , Rosemary Harrup 1 2
  1. Royal Hobart Hospital, Hobart, TAS, Australia
  2. Medical Oncology and Clinical Haematology, Royal Hobart Hospital, Hobart, Tasmania, Australia

Background: Cancer patients  have an increased risk of venous thromboembolism (VTE).  Patients with glioblastoma multiforme (GBM) are at higher risk compared to other cancers1. VTE risk in GBM has been reported to be as high as 28% per annum (1.5 – 2.0% per month)1.  Long term thromboprophylaxis for cancer patients is being explored2; however, is not currently supported in GBM1,2.  VTE treatment with low-molecular weight heparin (LMWH) remains the standard of care given a lack of evidence for direct-acting anticoagulants (DOAC) in this population, despite the convenience of DOAC administration.


To document rates of VTE in GBM patients in a single-institution.


 VTEs in patients with GBM were retrospectively identified by cross-matching coding data from Medical Imaging and inpatient medical record for all l GBM cases between 1/1/14- 31/12/17.


Fourteen of 65 (21.5%) of GBM patients were diagnosed with VTE. The majority were in ambulatory patients. Five episodes (33%) occurred in inpatients none of whom were receiving thromboprophylaxis. Five were managed with a DOAC (rivaroxaban), and seven with therapeutic enoxaparin (1mg/kg BD). There were no episodes of grade 3 or 4 bleeding or  recurrent VTEs . 



VTE n (%)

No VTE n(%)

Sex Male    55

       Female 20

12 (21.8)

2 (10.0)

33 (78.2)

18 (90.0)

Median age, years (range)

61 (38-78)

54 (17-79)



Inpatient n (%)

Ambulatory n (%)

Episodes of VTE (14)

5 (35.7)

9 (64.3)



Enoxaparin n (%)

Rivaroxaban n (%)

Unknown n (%)

Episodes of VTE (14 )

7 (50.0)

5 (35.71)

2 (16.7)




VTE is common in GBM, even in an ambulatory population. Prospective research to assess the risk-benefit ratio of primary pharmacological thromboprophylaxis in this population is needed. Investigation into the safety and efficacy of DOACs for both prevention and treatment in this population is also warranted.


  1. Perry JR. Thromboembolic disease in patients with high-grade glioma. Neuro-Oncol. 2012; 14:iv73-iv80
  2. Di Nisio M, Porreca E, Candeloro M, De Tursi M, Russi I, Ruties AWS. Primary prophylaxis for venous thromboembolism in ambulatory cancer patients receiving chemotherapy. Cochrane Database of Systematic Reviews2016, Issue 12. Art. No.: CD008500