Severe thrombosis and acute thrombocytopenia in a cancer patient

Hanzelka, Katy M.; Zalpour, Ali; Afshar-Kharghan, Vahid; Fitousis, Kalliopi; Anderlini, Paolo; Yeung, Sai Ching Jim

doi:10.1002/ajh.21808

Cited by 2 publications

(4 citation statements)

References 30 publications

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“…Regardless of this, the wide scatter of the AGA, and the presence of nearly 10% of the AGA in the patient group are consistent with the reported data in patients with cancer. 18 In our study, we also showed that there is an inverse relation between MP and AGA levels. This is due to the fact that there is an activation of platelets and formation of platelet MPs.…”

Section: Discussionsupporting

confidence: 73%

“…These platelet MPs also lead to thrombosis. Heparin Induced Thrombocytopenia (HIT) can be severe enough to lead death, 18,19 but there is lack of information regarding HIT antibodies and patients with cancer. The aim of this study is to find the prevalence of MPs, APL antibodies, and antiglycosaminoglycan antibodies (AGAs) in patients with bladder pathology in relation to VTE complication.…”

Section: Introductionmentioning

confidence: 99%

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Inflammation and Hemostatic Activation may Contribute to Postsurgical Thrombosis in Patients With Bladder Cancer

Abro

Clark

Barkan

et al. 2015

Clin Appl Thromb Hemost

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The alterations of the inflammatory and thrombotic components in patients with cancer are not clearly understood. The purpose of this study was to profile markers of inflammation and thrombotic activation specifically in the patients with bladder cancer undergoing radical cystectomy. For this study, 134 samples were collected from patients undergoing radical cystectomy. Antiphospholipid antibodies (immunoglobulin G subtype), microparticles, and antiglycosaminoglycan antibodies were measured with a commercially available enzyme-linked immunosorbent assay kits. These biomarkers were compared in patients with bladder cancer and normal individuals (n = 20). Patients had an average value of 6.7 ± 11.9 ng/mL (median: 2.8, confidence interval: 4.69-8.75, andPvalue: .0038) of antiphospholipid antibodies versus normal individuals 1.96 ± 0.9 ng/mL (median: 1.8 and confidence interval: 1.5-2.35). Microparticles level in patients was 8.31 ± 6.14 ng/mL, (median: 6.1, confidence interval: 7.26-9.37, andPvalue: <.0001) versus normal individuals 3.57 ± 2.34 ng/mL (median: 2.85 and confidence interval: 2.476-4.664). The antiglycosaminoglycan antibodies in patients had an average value of 0.22 ± 0.1 optical density (OD; median: 0.2, confidence interval: 0.21-0.24, andPvalue: .0213) compared to normal individuals 0.25 ± 0.08 OD (median: 0.25 and confidence interval: 0.22-0.23). The correlation of antiglycosaminoglycan antibodies with antiphospholipid antibodies showed Spearmanrvalue = .2364 (95% confidence interval: 0.05-0.4 andPvalue .009). The correlation of antiglycosaminoglycan antibodies versus microparticles showed Spearmanr= -.195 (95% confidence interval: 0.37-0.01 andPvalue .0321). These data suggest that patients with bladder cancer have subclinical activation of thrombotic and inflammatory processes that may be further exacerbated by surgical procedures and lead to venous thromboembolism-related complications.

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Section: Discussionsupporting

confidence: 73%

Section: Introductionmentioning

confidence: 99%

Inflammation and Hemostatic Activation may Contribute to Postsurgical Thrombosis in Patients With Bladder Cancer

Abro

Clark

Barkan

et al. 2015

Clin Appl Thromb Hemost

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“…HIT due to heparin exposure from flushes for vascular access devices is uncommon, 19 but it can occur with fatal consequences. 7 Another possible reason for our lower incidence rate compared with previous estimates is the inclusion of outpatients and patients with heparin exposure from flushes for vascular access devices in the denominator.…”

Section: Discussionmentioning

confidence: 77%

“… 4 , 5 HIT can potentially result in death, 6 and recently, we reported a fatal case of HIT in a cancer patient. 7 There is a lack of information regarding HIT among cancer patients. 8 A retrospective study of 55 HIT patients in a Canadian tertiary care hospital reported 11 patients with malignancies and 44 patients without malignancies, and the odds for developing HIT was significantly higher in cancer patients than non-cancer patients in an inpatient setting.…”

Section: Introductionmentioning

confidence: 99%

Heparin-induced thrombocytopenia among patients of a comprehensive cancer center

Merriman

Nabaah

et al. 2014

SAGE Open Medical Case Reports

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Most clinical studies of heparin-induced thrombocytopenia have not included cancer patients who have high risk of thromboembolism, frequent exposure to heparin, and many potential causes of thrombocytopenia other than heparin-induced thrombocytopenia. To estimate the incidence and prevalence of heparin-induced thrombocytopenia in cancer patients, we identified cases based on diagnostic codes, anti-heparin antibody testing, and clinical characteristics (4T score) at a comprehensive cancer center between 1 October 2008 and 31 December 2011. We estimated that the prevalence of heparin-induced thrombocytopenia to be 0.02% among all cancer patients and 0.24% among cancer patients exposed to heparin. The annual incidence of heparin-induced thrombocytopenia was 0.57 cases per 1000 cancer patients exposed to heparin. Of the 40 cancer patients with the International Classification of Diseases (Ninth Revision; ICD-9) code for heparin-induced thrombocytopenia, positive anti-heparin antibody, and 4T score ≥4, 5 (12.5%) died of related thromboembolic or hemorrhagic complications. In a multivariate logistic regression model, male gender was a significant (p = 0.035) factor, and non-hematological malignancy was a significant (p = 0.017) factor associated with anti-heparin antibody positivity. Future studies may further examine the risk factors associated with heparin-induced thrombocytopenia in larger cohorts.

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Severe thrombosis and acute thrombocytopenia in a cancer patient

Cited by 2 publications

References 30 publications

Inflammation and Hemostatic Activation may Contribute to Postsurgical Thrombosis in Patients With Bladder Cancer

Inflammation and Hemostatic Activation may Contribute to Postsurgical Thrombosis in Patients With Bladder Cancer

Heparin-induced thrombocytopenia among patients of a comprehensive cancer center

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