Abnormalities of Blood Coagulation Tests in Patients with Cancer

Abstract

Routine blood coagulation tests were performed on 431 consecutive patients enrolled in a study of the role of anticoagulation in cancer treatment (VA Cooperative Study #75). Two hundred sixteen control patients were treated with standard therapy, and 215 patients were treated with standard therapy plus sodium warfarin. At the time of entry into the study, the most common abnormalities were elevated fibrinogen levels, platelet counts, and fibrinopeptide A levels. Serial studies demonstrated a steady increase in platelet count and fibrinogen levels before death. Anticoagulation lowered FPA levels but had no significant effect on fibrinogen levels, platelet counts, or euglobulin clot lysis times. An unexpected finding was a dramatic increase in fibrin split product levels after institution of anticoagulation (means +/- SEM = 42.6 +/- 116.4 vs. 2.9 +/- 7.0 mg/L in control subjects; P less than 0.02). This study supports the presence of subclinical activation of blood coagulation in most patients with cancer. Moreover, the preferential activation of fibrinolysis in anticoagulated patients suggests a role for a vitamin K-dependent factor(s) in the regulation of fibrinolysis in patients with cancer.

The phospholipid code: a key component of dying cell recognition, tumor progression and host–microbe interactions

“…It is well documented that activation of the blood coagulation cascade is a common feature of cancer and is associated with increased malignancy and poor outcomes. [33][34][35] Under non-pathological conditions, activation of the blood coagulation cascade is triggered in response to tissue injury or trauma and occurs through the activation of a suite of coagulation factors and complexes. 36 It is initiated by exposure of the subendothelial transmembrane glycoprotein, tissue factor (TF), to blood, where it forms a complex with circulating factor VIIa (TF:FVIIa).…”

Comparison of natural and recombinant tissue factor proteins: new insights

“…Monocytes and macrophages are known to express TF upon stimulation by inflammation-related agents (Nijziel et al , 2001 ;Broussas et al , 2002 ;Levi et al , 2006 ). In addition to normal tissues and cells, TF is also known to be expressed by tumor cells, where it is related to the metastatic potential of those cells (Edwards et al , 1981 ;Lopez -Pedrera et al, 2006 ). Furthermore, a role for TF in the progression of cardiovascular disease has been suggested (Mumford and McVey , 2004 ;Jude et al , 2005 ).…”

Arterio-venous gradients of IL-6, plasma and serum VEGF and D-dimers in human cancer

“…In addition, fibrin-(ogen) degradation products have pro-angiogenic properties (Thompson et al, 1985;Stirk et al, 2000). Remarkably, high fibrinolytic derivatives are one of the most frequent coagulation test abnormalities encountered in the oncological setting (Edwards et al, 1987).…”