Predicting the risk of recurrent venous thromboembolism in patients with cancer: A prospective cohort study

Es, Nick van; Louzada, Martha L; Carrier, Marc; Tagalakis, Vicky; Gross, Peter L.; Shivakumar, S; Rodger, Marc; Wells, Philip S.

doi:10.1016/j.thromres.2018.01.009

Cited by 35 publications

(32 citation statements)

References 23 publications

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“…However, even when cancer patients are treated with an anticoagulant, they remain at high risk for recurrent thrombosis [ 55 , 56 ]. Increased soluble P-selectin in serum is a risk factor for recurrent thrombosis [ 57 ]. Notably, whether lung cancer patients were taking any type of antiplatelet or anticoagulant drug did not influence PTCA formation nor P-selectin expression within PTCAs (not shown), indicating that PTCA formation may provide clinically useful insight with respect to cancer and thrombosis risk, including recurrent thrombosis.…”

Section: Discussionmentioning

confidence: 99%

Platelet-T cell aggregates in lung cancer patients: Implications for thrombosis

et al. 2020

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Platelet-leukocyte aggregates (PLAs) are associated with increased thrombosis risk. The influence of PLA formation is especially important for cancer patients, since thrombosis accounts for approximately 10% of cancer-associated deaths. Our objective was to characterize and quantify PLAs in whole blood samples from lung cancer patients compared to healthy volunteers with the intent to analyze PLA formation in the context of lung cancer-associated thrombosis. Consenting lung cancer patients (57) and healthy volunteers (56) were enrolled at the Dana Cancer Center at the University of Toledo Health Science Campus. Peripheral blood samples were analyzed by flow cytometry. Patient medical history was reviewed through electronic medical records. Most importantly, we found lung cancer patients to have higher percentages of platelet-T cell aggregates (PTCAs) than healthy volunteers among both CD4+ T lymphocyte and CD8+ T lymphocyte populations. Our findings demonstrate that characterization of PTCAs may have clinical utility in differentiating lung cancer patients from healthy volunteers and stratifying lung cancer patients by history of thrombosis.

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Section: Discussionmentioning

confidence: 99%

Platelet-T cell aggregates in lung cancer patients: Implications for thrombosis

et al. 2020

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“…PE is a clinical syndrome in which an artery in the lungs is blocked by a substance such as a gas or thromboembolism, with a thromboembolism being the most common cause. Cancer is a well-known risk factor for PE, and lung cancer is the most common malignancy coexisting in patients with PE [12]. Studies have demonstrated that the risk of thromboembolic events in patients with cancer is much greater than that in the general population [13], with some studies reporting that patients with cancer are at a 4-7-fold higher risk of PE than those without cancer [5,14].…”

Section: Discussionmentioning

confidence: 99%

Rare cause of repeated pulmonary embolism: a case of primary pleural squamous cell carcinoma and literature review

et al. 2020

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Background: Malignant tumors are risk factors for a pulmonary embolism (PE), and a PE caused by a tumor is not uncommon. Primary pleural squamous cell carcinoma (PPSCC) is a rare malignancy; thus, a related PE is extremely rare. Case presentation: A previously healthy 49-year-old female patient was admitted to Northern Jiangsu People's Hospital owing to chest tightness, cough, and breathing difficulty that persisted for 3 days. Following admission, a computed tomography (CT) pulmonary angiography revealed an embolism in the main pulmonary artery, upper and lower pulmonary artery branch. The patient was treated with alteplase, warfarin, and antibiotics. Over the following year, she experienced recurrent chest pain and tightness and breathing difficulty, with multiple CT pulmonary angiography revealing thrombosis in the right and left main pulmonary artery. No abnormalities were observed in surrogate markers of autoimmune diseases, tumor antigen testing, or ultrasonography; thus, the cause of recurrent PE was not identified. Subsequently, a positron emission tomography-computed tomography (PET-CT) examination revealed diffuse heterogeneous thickening of the right pleura and substantially increased glucose metabolism. A CT-guided pleural biopsy was performed, and histopathological examination of the pleura eventually revealed a diagnosis of PPSCC. Conclusions: PPSCC is a rare tumor that lacks specific clinical manifestations and is difficult to detect with imaging techniques. The occurrence of PE as the primary manifesting symptom in a patient with PPSCC is extremely rare. Thus, malignant tumors should be considered in patients with no risk factors for PE and/or in those with recurrent PE. An immediate diagnosis and adequate intervention can be achieved with increased awareness of this diagnosis and subsequent related examinations.

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“…A score ≤0 corresponds with a low risk (≤4.5%) and score ≥1 corresponds with a high risk (≥19%) of VTE recurrence within 6 months. Attempts to validate this model in other populations have yielded conflicting results 19, 20. A subsequent small prospective study showed that baseline soluble P‐selection, but not D‐dimer, was associated with increased risk of recurrent cancer‐associated thrombosis 20.…”

Section: Risk Factors Of Cancer‐associated Thrombosismentioning

confidence: 99%

“…Attempts to validate this model in other populations have yielded conflicting results. 19,20 A subsequent small prospective study showed that baseline soluble P-selection, but not D-dimer, was associated with increased risk of recurrent cancer-associated thrombosis. 20 Other studies have identified additional risk factors for recurrent VTE.…”

Section: Risk Factors Of Cancer-associated Thrombosismentioning

confidence: 99%

“…19,20 A subsequent small prospective study showed that baseline soluble P-selection, but not D-dimer, was associated with increased risk of recurrent cancer-associated thrombosis. 20 Other studies have identified additional risk factors for recurrent VTE. For example, in the Olmstead County population based cohort study, cancer type, stage, stage progression, and leg paresis were significant risk factors, 21 while elevated tissue factor, venous compression, and hepatobiliary cancer were identified as risk factors in the CATCH study.…”

Section: Risk Factors Of Cancer-associated Thrombosismentioning

confidence: 99%

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Managing thrombosis in cancer patients

Wang

García

2018

Research and Practice in Thrombosis and Haemostasis

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Venous thromboembolism is a major complication in cancer patients. The basis for the strong association between cancer and thrombosis remains incompletely understood, and the optimal approaches to both the treatment and the prevention of cancer‐associated thrombosis are evolving. Here we review several important topics related to cancer‐associated thromboembolism, including the pathogenesis, prevention, and management of this disease. Wherever possible, we include evidence from clinical trials, including the results of recently published trials that compared direct oral anticoagulants to low‐molecular‐weight heparin for the treatment of cancer‐associated thrombosis.

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Predicting the risk of recurrent venous thromboembolism in patients with cancer: A prospective cohort study

Cited by 35 publications

References 23 publications

Platelet-T cell aggregates in lung cancer patients: Implications for thrombosis

Platelet-T cell aggregates in lung cancer patients: Implications for thrombosis

Rare cause of repeated pulmonary embolism: a case of primary pleural squamous cell carcinoma and literature review

Managing thrombosis in cancer patients

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