Adverse effects on hemostatic function of drugs used in hematologic malignancies.

The adverse effects of drugs used in the treatment of hematologic malignancies are among the many factors contributing to the increased risk of both thrombosis and bleeding. These effects most often occur when combination of drugs are given. Some, such as L-asparaginase, result in both bleeding and thrombosis. Consideration must be given also to the bleeding or prothrombotic risk of the underlying hematologic disorder. The commonly used drugs with adverse effects on hemostasis include L-asparaginase, corticosteroids, inhibitors of vascular endothelial growth factor, gemtuzumab ozogamicin, thalidomide, and immunomodulatory derivatives of Thalidomide, and the hematopoietic growth factors. In addition, the syndrome of thrombotic microangiopathy may be brought on by several other drugs. Thus, a full understanding of these adverse effects is necessary in treating these disorders.