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In the field of thrombosis and hemostasis the focus was laid on the prophylaxis and treatment of venous thromboembolism in patients with active cancer during this years’ meeting of the American Society of Hematology (ASH) in San Diego. The Adam-VTE trial completed the series of studies using Xa-antagonists for the treatment of cancer-associated thromboembolism. Apixaban reduced the number of recurrent thromboembolic events compared to treatment with dalteparin without increasing the bleeding risk. Furthermore, the use of a prophylactic dose of rivaroxaban or apixaban showed positive results in the primary prevention of venous thromboembolism in ambulatory cancer patients being at high risk for thromboembolic events. A safe standardized perioperative management for direct oral anticoagulants was also presented during the meeting in noncancer patients with atrial fibrillation. This short review will summarize the most clinically relevant highlights in the field of thrombosis and hemostasis of the ASH meeting 2018.