Thesis (M.Sc.) - Cairo University - Faculty of Pharmacy - Department of Pharmacology and Toxicology

The purpose of this study was to determine the effect of tinzaparin on certain coagulation parameters that were chosen in accordance with a risk model developed for cancer patients who were prone to develop deep venous thrombosis. In addition, the safety and efficacy of tinzaparin as a prophylactic low molecular weight heparin on deep venous thrombosis was also determined. The study chose forty newly diagnosed adult patients with breast or lung cancer subjected only to chemotherapy (5-fluorouracil-adriamycin-cyclophosphamide [FEC], adriamycin-cyclophosphamide [AC], or cisplatin+gemcitabine [Cis+Gem]). Using closed envelope method, patients were randomly assigned into either control group (chemotherapy only) or subjected in addition to their chemotherapy to tinzaparin prophylactic dose of 4500 IU subcutaneously for 28 consecutive days within 4 weeks post-operatively, if present. They were followed up for another month for detection of deep venous thrombosis. Blood samples were collected from both groups before the start of chemotherapy and after 28 days. There was neither liver/kidney toxicity nor deep venous thrombosis during the follow up of tinzaparin group, while two patients had developed thrombosis in the non treated group; one has died following the administration of his first chemotherapeutic dose and the other has developed right leg deep venous thrombosis. Although there were insignificant changes, platelet and total leucocytes counts and activated partial thromboplastin time tended to be altered in the tinzaparin group compared to control patients; the higher risk score might increase deep venous thrombosis in the control. Tinzaparin could be safely used in newly diagnosed high risk breast and lung cancer patients with no bleeding or organ dysfunction in the prophylaxis of deep venous thrombosi

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