Isabelle Mahé: Frailty Does Not Mean Less Anticoagulation
Isabelle Mahé, Head of Internal Medicine at the Louis Mourier Hospital, APHP at Paris Cité University, shared a post on LinkedIn about several recent articles she and her colleagues co-authored, published in Blood Advances, adding:
”In clinical practice, clinicians are often more concerned about bleeding risk in CAT patients presenting with frailty markers.
However, whether the risk of recurrent VTE and the risk of bleeding during anticoagulant therapy are actually higher in frail CAT patients remains poorly assessed.
This meta-analysis including Individual Patient Data (N equals 1413) from four prospective studies of CAT patients treated with standard full-dose tinzaparin (LMWH), with follow-up up to six months, showed that:
First, VTE recurrence risk, unlike bleeding risk, varied according to tumor site and frailty markers including age greater than or equal to 75 years, CrCl less than 50 mL/min, body weight less than or equal to 50 kg, and ECOG greater than or equal to 2.
Second, compared with non-frail patients, frail CAT patients experienced a higher risk of recurrent VTE without an increased risk of major bleeding.
Third, as frailty factors accumulated, the risk of recurrent VTE increased, whereas the risk of major bleeding did not.
Key messages from this analysis:
These findings refine the clinical understanding that cancer type and frailty, often perceived as markers of bleeding risk, may primarily identify patients at higher risk of recurrent VTE rather than bleeding when treated with full-dose LMWH.
Frailty alone should not be considered a contraindication to anticoagulation, even when bleeding risk factors are present.
Importantly, these results do not support routine LMWH full-dose reduction in frail CAT patients.”
Title 1: LMWH dose reduction in CAT: not so fast!
Authors: Abdelrahman Noureldin, Marc Carrier

Title 2: Complications in patients with cancer-associated thrombosis on tinzaparin by cancer site and frailty: a pooled analysis
Authors: Isabelle Mahé, Céline Chapelle, Philippe Girard, Luis Jara-Palomares, Agnes Y. Y. Lee, Olivier Sanchez, Guy Meyer, Patrick Mismetti, Silvy Laporte

Stay updated on all scientific advances with Hemostasis Today.
-
May 26, 2026, 12:32Behçet Syndrome and Thrombosis: When Inflammation Becomes a Clot
-
May 26, 2026, 12:29Priya Prasad: When Blood Becomes the Battlefield – Transfusion Medicine Saves Lives
-
May 26, 2026, 12:21Mavis Agnes Kisakye: Uganda at the WFH Regional Conference on Blood Disorders
-
May 26, 2026, 12:19Megan Adediran: Giving Hope to People Living with Bleeding Disorders
-
May 26, 2026, 11:36Abid Ur Rahman: Understanding the Coagulation Cascade and Hemostasis
-
May 26, 2026, 11:35Isaac Okello: The Real Sickle Cell Crisis Is Not Only the Disease Itself
-
May 26, 2026, 11:34Ziad Omar: PTT and aPTT Testing – Reading the Intristic Pathway of Coagulation
-
May 26, 2026, 11:33Megan Griffiths: Advancing the Understanding of Risk and Outcomes in Pulmonary Hypertension
-
May 26, 2026, 11:30Samantha Pasca: How Should We Manage Cardiovascular Disease in Patients With Hemophilia?