Dalteparin in Preventing DVT in Participants With Cancer

Inclusion Criteria:

GROUP A
Metastatic disease, myeloma, lymphoma.
Pathologic fracture or impending pathologic fracture of the femur.
Intramedullary rod, plating, cementation, hip arthroplasty, or knee arthroplasty.
GROUP B
Primary sarcoma of bone or soft tissue of the lower extremity.
T2 tumor (> 5 cm by < 20 cm).
Radical resection of tumor, which may necessitate major bone or soft tissue reconstruction.

Exclusion Criteria:

Presence of DVT on pre-operative screening ultrasound study.
Massive tumor (> 20 cm in greatest dimension).
Amputation of the affected leg as treatment of tumor.
Estimated blood loss > 2 liters during surgery.
Surgical drain output > 500 cc of bloody fluid during first 8 hours.
International normalized ratio (I.N.R.) > 1.3 pre-operatively or > 1.5 post-operatively.
Platelet count < 100,000 either pre-operatively or post-operatively.
Indwelling post-operative epidural catheter for pain control.
History of underlying bleeding disorder, such as hemophilia.
History of adverse reaction to heparin such as heparin-induced thrombocytopenia.
Severe liver or renal insufficiency.
History of hypertensive or diabetic retinopathy.
History of gastro-intestinal bleeding within 12 months.
Treatment with warfarin, clopidogrel, aspirin, nonsteroidal antiinflammatory drugs (NSAIDs), low molecular weight heparin (LMWH) or other anti-coagulants for conditions.
History of stroke.
Women of child bearing potential having a positive urine or serum pregnancy test (human chorionic gonadotropin [hCG]) at the time of pre-operative evaluation (within 7 days of surgery).
Women who are breastfeeding.
Hemoglobin < 8.0 g/dL.
Platelet count < 100,000/L.
Alanine aminotransferase > 100 IU/L.
Aspartate aminotransferase > 100 IU/L.
Direct bilirubin > 0.5mg/dL.
Serum creatinine > 2.0 mg/dL.
Patients taking COX-2 inhibitors.
Patients who have fragmented mechanical heart valves.