{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T06:44:53Z","timestamp":1764657893903,"version":"3.46.0"},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T00:00:00Z","timestamp":1762732800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Patients with cancer\u2010associated thrombosis (CAT) are commonly treated with low\u2010molecular\u2010weight heparin (LMWH), but whether dose capping is needed in patients over 90\u2009kg is unclear. We conducted the WAVe study, a multicenter prospective cohort study in adult patients (\u2265\u200918\u2009years) with acute CAT and a weight of over 90\u2009kg starting anticoagulation. Patients received weight\u2010adjusted dalteparin at 200\u2009IU\/kg per day (up to 33\u2009000\u2009IU) for 30 (\u00b1\u20094) days, after which anticoagulation was continued per clinician discretion and followed for 6\u2009months. The primary outcome was major bleeding (MB) at 30\u2009days. Secondary outcomes included objectively confirmed recurrent venous thromboembolism (VTE) at 30\u2009days and trough anti\u2010Xa levels. The cumulative incidences of outcomes were estimated by time\u2010to\u2010event analysis, with death as a competing risk. The study stopped early due to recruitment challenges after 91 patients. Median weight and daily dose of dalteparin were 107.5\u2009kg and 22\u2009500\u2009IU, respectively. Three patients had a MB episode for a cumulative incidence of 5.3% (95% CI 1.1%\u201314.8%) at 30\u2009days. One patient had recurrent VTE for a cumulative incidence of 1.2% (95% CI 0.1%\u20135.7%) at 30\u2009days. No significant bioaccumulation noted up to Day 30 based on trough anti\u2010Xa levels. The median Day 7 trough anti\u2010Xa levels were higher in those with bleeding events within 30\u2009days compared to those without (0.6 vs. 0.2\u2009IU\/mL,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.01). Our results suggest that weight\u2010adjusted dosing of dalteparin in patients over 90\u2009kg is associated with acceptable rates of bleeding and thrombosis.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Trial Registration:<\/jats:bold>\n                    NCT03297359\n                  <\/jats:p>","DOI":"10.1002\/ajh.70127","type":"journal-article","created":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T12:26:11Z","timestamp":1762777571000},"page":"79-88","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Multicenter Prospective Cohort Study on the Use of Weight\u2010Adjusted Dalteparin in Patients Over 90\u2009kg With Acute Cancer\u2010Associated Venous Thromboembolism\u2014The\n                    <scp>WAVe<\/scp>\n                    Study"],"prefix":"10.1002","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2407-9000","authenticated-orcid":false,"given":"Tzu\u2010Fei","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Medicine, Ottawa Hospital Research Institute University of Ottawa at the Ottawa Hospital  Ottawa Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erik","family":"Yeo","sequence":"additional","affiliation":[{"name":"Department of Medicine University Health Network, University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter L.","family":"Gross","sequence":"additional","affiliation":[{"name":"Department of Medicine University Health Network, University of Toronto  Toronto Ontario Canada"},{"name":"Department of Medicine McMaster University  Hamilton Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chantal","family":"S\u00e9guin","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Hematology McGill University  Qu\u00e9bec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cynthia","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Hematology University of Alberta  Edmonton Alberta Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sudeep","family":"Shivakumar","sequence":"additional","affiliation":[{"name":"Department of Medicine, Nova Scotia Health Dalhousie University  Halifax Nova Scotia Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ranjeeta","family":"Mallick","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Program Ottawa Hospital Research Institute  Ottawa Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0227-1245","authenticated-orcid":false,"given":"Aur\u00e9lien","family":"Delluc","sequence":"additional","affiliation":[{"name":"Department of Medicine, Ottawa Hospital Research Institute University of Ottawa at the Ottawa Hospital  Ottawa Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julien","family":"D'Astous","sequence":"additional","affiliation":[{"name":"Department of Medicine Centre hospitalier de l'Universit\u00e9 de Montr\u00e9al, Universit\u00e9 de Montr\u00e9al  Montr\u00e9al Qu\u00e9bec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miriam","family":"Kimpton","sequence":"additional","affiliation":[{"name":"Department of Medicine, Ottawa Hospital Research Institute University of Ottawa at the Ottawa Hospital  Ottawa Ontario 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of Bern  Bern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gr\u00e9goire","family":"Le Gal","sequence":"additional","affiliation":[{"name":"Department of Medicine, Ottawa Hospital Research Institute University of Ottawa at the Ottawa Hospital  Ottawa Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc","family":"Carrier","sequence":"additional","affiliation":[{"name":"Department of Medicine, Ottawa Hospital Research Institute University of Ottawa at the Ottawa Hospital  Ottawa Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,11,10]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"World Health Organization \u201cObesity and Overweight \u201d2018 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