Study Of Weight-Based Versus Standard Dose Enoxaparin Thromboprophylaxis In High-Risk Hospitalized Cancer Patients

Inclusion Criteria:

* Participants must have histologically or cytologically confirmed diagnosis of solid tumor malignancy, lymphoma or multiple myeloma.
* Cancer diagnosis or received treatment (chemotherapy or radiotherapy) for malignancy within the previous 6 months
* One or more Padua-based risk factor:

  * History of previous venous thromboembolic event (excluding superficial vein thrombosis)
  * Reduced mobility (ECOG performance status 3 or 4, see Appendix A)
  * Established hereditary thrombophilia (e.g. Factor V Leiden, G20210 prothrombin mutation, protein C or S deficiency, antithrombin deficiency).
  * Recent surgery within the last 30 days
  * Age ≥ 70 years
  * Congestive heart failure (NYHA class III or IV)
  * Complicated respiratory insufficiency (defined as an increased requirement for supplementary oxygen of at least 2L)
  * Acute myocardial infarction or ischemic stroke
  * Obesity (BMI ≥ 30)
  * Receiving hormonal agents (e.g. tamoxifen, estrogen, testosterone)
  * Acute infection (i.e. requiring antimicrobial therapy)
* Age ≥ 18 years
* Life expectancy of greater than 30 days
* Platelet count ≥ 100,000/mcL
* Creatinine \< 1.5 mg/dL or estimated creatinine clearance ≥ 50 mL/min/1.73 m2
* Ability to understand and the willingness to sign a written informed consent document
* Weight between 50kg to 130 kg.

Exclusion Criteria:

* History of allergic reactions attributed to heparin or low molecular weight heparin
* Active bleeding or otherwise considered high risk for hemorrhage (e.g. known acute gastrointestinal ulcer)
* Any history of significant hemorrhage (requiring hospitalization or transfusion) within the last 6 months (excluding hemorrhage during operative procedure).
* History of heparin induced Thrombocytopenia
* Presence of coagulopathy (PT or PTT\> 1.2 x upper limit of normal)
* Known diagnosis of disseminated intravascular coagulation
* Currently receiving therapeutic anticoagulant therapy or dual antiplatelet therapy (eg. aspirin and clopidogrel)
* Uncontrolled arterial hypertension (systolic blood pressure \> 200mmHg, diastolic \>110mmHg)
* Active peptic ulcer disease
* Bacterial Endocardititis
* Received any type of Pharmacologic Thromboprophylaxis (e.g. low molecular weight heparin or heparin) for \>48 hours during current hospitalization
* Known brain metastases