A prospective study of hemostatic abnormalities in 108 cancer patients was undertken at an oncology clinic in a university teaching hospital. Tests included Quick prothrombin time, activated partial thromboplastin time, thrombin time, platelet count, modified Ivy bleeding time, fibrinogen, fibrin degradation products (FDP), euglobulin lysis time, protamine sulfate test, and factor V, VII, VIII and X assays. Ninety-eight per cent of the patients had one or more abnormal coagulation tests. The commonest abnormalities were elevated fibrin degradation products and prolonged thrombin time. Thrombocytosis occurred in 57% of patients, hyperfibrinogenemia in 46%, thrombocytopenia in 11%, and non had hypofibrinogenmia. It is suggested that platelet count, fibrinogen concentration, and serum FDP assay are the most useful tests in assessing the hemostatic abnormalities in cancer patients, although thrombin time, factor V assay, and bleeding time may also be helpful. The peripheral blood smears of 53 patients were reviewed, and only one showed microangiopathic hemolytic anemia. The data illustrate that subclinical coagulopathy is relatively frequent in patients with malignancy.

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The experience of Mitomycin-C given as a once weekly intraveneous injection for carcinoma of gastroenteric and breast origin with review of recent literature is given. Limited activity was seen in gastric and colorectal carcinoma. Similar to the experience of others, hematological toxicity (thrombocytopenia and/or leukopenia) was the dose-limiting toxicity encountered. Although the once weekly schedule was not directly compared with other reported schedules, it seems clear there was no reduction of significant and dose-limiting hematological toxicity nor enhancement of therapeutic efficacy.