Lupus Anticoagulant Activity as a Thrombosis Risk Factor in Lung Adenocarcinoma Patients

Meis, Ernesto de; Pinheiro, Vera R.; Loures, M. A.; Kotouc, Maria Mercedes; Zamboni, Mauro; Guedes, Maria T.S.; Barros, Ailce S.; Castilho, Ilda A.M.; Levy, Roger A.

doi:10.1196/annals.1381.006

Cited by 6 publications

(8 citation statements)

References 20 publications

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“…The incidence of DVT in our study was higher than those about 11% and 1% to 8% reported by other studies. 15 , 19 The difference may result from different population race, verification of venous thrombosis, and longer courses of disease before diagnosis of the patients in this study.…”

Section: Discussionmentioning

confidence: 83%

“… 3 Patients at risk for thrombosis were characterized by the presence of LAC, and the thrombosis risk is connected solely with the presence of LAC. 14 , 15 A retrospective study has showed that LAC was the risk factor of thrombosis in patients with lung cancer. 16 Although LAC seems to be associated with thrombosis in patients with LAC-positive, the pathogenesis is actually unclear.…”

Section: Introductionmentioning

confidence: 99%

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Clinical and Prognostic Significance of Lupus Anticoagulant Measurement in Patients With Lung Cancer

Fei

Wang

Jiang

et al. 2017

Technol Cancer Res Treat

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Lupus anticoagulants is related to both recurrent thrombosis and cancer. Thrombotic complications occur more frequently in patients with lung cancer. The aim of this study is to investigate the association of lupus anticoagulants with hypercoagulability and thrombotic complications, as well as prognostic significance of lupus anticoagulants for patients with lung cancer. The study comprised 205 patients with non–small cell lung cancer. Plasma normalized LAC ratio, D-dimer, fibrinogen, activities of antithrombin, and FVIII before treatment were analyzed by coagulation analyzer, and routine hematologic and biochemical parameters were also evaluated. In patients, normalized LAC ratio, D-dimer, fibrinogen, and procoagulant activity of coagulating factor VIII levels significantly increased, whereas antithrombin activity significantly decreased compared with healthy controls (P < .001). Normalized LAC ratio was positively correlated with D-dimer, fibrinogen, and procoagulant activity of coagulating factor VIII, and negatively correlated with antithrombin activity, respectively (P < .01). D-dimer, procoagulant activity of coagulating factor VIII, and antithrombin levels revealed statistical difference in non–deep venous thrombosis patients with elevated or normal normalized LA ratio (P < .05). The incidence of deep venous thrombosis and tumor metastasis was higher, and 1-year survival rate was lower in elevated normalized LAC ratio patients than in normal ones, respectively (P < .01). There was higher normalized LAC ratio level in patients with deep venous thrombosis and/or metastasis (P < .05). In 1-year deceased patients, normalized LAC ratio level and the incidence of deep venous thrombosis and metastasis were higher than those in survivors, respectively (P < .05). Hazard regression analysis demonstrated normalized LAC ratio was independently associated with short survival time in patients with non–small cell lung cancer (hazard regression: 2.871, 95%confidence interval: 1.704-4.835; χ2: 19.130; P < .01). Our study suggests that lupus anticoagulants is a useful marker to predict thrombotic complications and prognosis in patient with lung cancer.

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Section: Discussionmentioning

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Clinical and Prognostic Significance of Lupus Anticoagulant Measurement in Patients With Lung Cancer

Fei

Wang

Jiang

et al. 2017

Technol Cancer Res Treat

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“…In fact, the notion that cancer patients positive for aPL antibodies are at high risk for thrombosis and have worse prognoses has only recently been introduced. 2 , 3 Moreover, a recent hypothesis postulates that even transient aPL antibodies may be implicated in the pathogenesis of thrombosis. 13 Only two studies addressed the issue of LAC antibodies in critically ill patients.…”

Section: Discussionmentioning

confidence: 99%

“… 1 The presence of aPL antibodies has been described in cancer patients 1 and was recently associated with an increased rate of thrombosis and a worse prognosis. 2 , 3 In cancer patients, aPL autoantibodies may represent a detectable link and a marker of crosstalk between the coagulation and immune systems. The catastrophic aPL syndrome (CAPS, Asherson’s syndrome) is considered a rare and severe form of aPL syndrome, often associated with multiple organ failure (MOF) and death.…”

Section: Introductionmentioning

confidence: 99%

“…The catastrophic aPL syndrome (CAPS, Asherson’s syndrome) is considered a rare and severe form of aPL syndrome, often associated with multiple organ failure (MOF) and death. 4 This autoimmune response is described in many pathologic situations, including infections 5 and cancer, 3 and results in the emergence of autoantibodies, such as aPL, in a permanent or transient manner. 6 Cancer patients are frequently exposed to severe septic shock and systemic inflammatory response syndrome (SIRS).…”

Section: Introductionmentioning

confidence: 99%

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Antiphospholipid Antibodies and Multiple Organ Failure in Critically Ill Cancer Patients

Salluh

Soares²,

Meis

2009

Clinics

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OBJECTIVES: To describe the clinical outcomes and thrombotic events in a series of critically ill cancer patients positive for antiphospholipid (aPL) antibodies. DESIGN: Retrospective case series study. SETTING: Medical-surgical oncologic intensive care unit (ICU). Patients and Participants: Eighteen patients with SIRS/sepsis and multiple organ failure (MOF) and positive for aPL antibodies, included over a 10-month period. INTERVENTIONS: None MEASUREMENTS AND RESULTS: aPL antibodies and coagulation parameters were measured up to 48 hours after the occurrence of acrocyanosis or arterial/venous thrombotic events. When current criteria for the diagnosis of aPL syndrome were applied, 16 patients met the criteria for “probable” and two patients had a definite diagnosis of APL syndrome in its catastrophic form (CAPS). Acrocyanosis, arterial events and venous thrombosis were present in eighteen, nine and five patients, respectively. Sepsis, cancer and major surgery were the main precipitating factors. All patients developed MOF during the ICU stay, with a hospital mortality rate of 72% (13/18). Five patients were discharged from the hospital. There were three survivors at 90 days of follow-up. New measurements of lupus anticoagulant (LAC) antibodies were performed in these three survivors and one patient still tested positive for these antibodies. CONCLUSIONS: In this small series of patients, we observed a high frequency of auto-antibodies and micro- and macro-vascular thrombotic events in critically ill cancer patients. The coexistence of sepsis or SIRS and aPL antibodies was often associated with MOF and death. More studies are necessary to determine the pathophysiological significance of antiphospholipid antibodies in severely ill cancer patients.

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Lung adenocarcinoma and antiphospholipid antibodies

Meis¹,

Monteiro²,

Levy³

2009

Autoimmunity Reviews

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Lupus Anticoagulant Activity as a Thrombosis Risk Factor in Lung Adenocarcinoma Patients

Cited by 6 publications

References 20 publications

Clinical and Prognostic Significance of Lupus Anticoagulant Measurement in Patients With Lung Cancer

Clinical and Prognostic Significance of Lupus Anticoagulant Measurement in Patients With Lung Cancer

Antiphospholipid Antibodies and Multiple Organ Failure in Critically Ill Cancer Patients

Lung adenocarcinoma and antiphospholipid antibodies

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