Thromboelastography Identifies Hypercoagulablilty and Predicts Thromboembolic Complications in Patients with Prostate Cancer

Toukh, Mazen; Siemens, D. Robert; Black, Angela; Robb, Sylvia; Leveridge, Michael; Graham, Charles H.; Othman, Maha

doi:10.1016/j.thromres.2013.10.007

Cited by 64 publications

(76 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…28 Previous studies have documented a potential association between ADT and increased venous and arterial TE risk in PCa patients. 20,22,29 These studies, however, failed to explore the direct impact of ADT on coagulation and the independent role of disease burden. In this current study, we provide evidence that advanced cancer alone may contribute to increased coagulability, as the majority of our cohort demonstrated hyercoagulable TEG findings before initiation of ADT and this did not appear to increase over time.…”

Section: Discussionmentioning

confidence: 99%

“…Data were collected for 75-90 minutes and the following major parameters were evaluated: R time, alpha (α) angle, maximum amplitude (MA) and clotting index (CI), time to clot formation (R), speed of clot propagation (α), rate of clot formation (K), strength/stability of clot (MA), and clotting index (CI; a value that is based on the four parameters above). As previously described, 22 hypercoagulability in any individual patients was defined as two or more TEG parameters with values beyond one standard deviation of the control. To assess the global difference in coagulability among the different groups, the averages of each TEG parameter among these groups were compared.…”

Section: Methodsmentioning

confidence: 99%

“…[19][20][21] More recently, our group has shown in a small cross-sectional series that PCa patients on ADT exhibit increased hypercoagulability, with a subsequent association with venous/arterial TE events. 22 The aim of the current study was to more closely examine a cohort of advanced PCa patients in a longitudinal study to better determine the contribution of ADT to coagulation status over time.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effects of androgen-deprivation therapy on hypercoagulability in prostate cancer patients: A prospective, longitudinal study

Kaur¹,

Black

Robb

et al. 2017

CUAJ

Self Cite

View full text Add to dashboard Cite

Introduction: Androgen-deprivation therapy (ADT) is the mainstay of systemic therapy for advanced prostate cancer (PCa), but has significant adverse effects, including increasing concern for cardiovascular (CV) and thromboembolic (TE) complications. This study carefully investigates any relationship between ADT use and hypercoagulability as a possible mechanism of these adverse effects. Methods: We performed a prospective, longitudinal study in a cohort of patients with advanced PCa initiating ADT (n=18). Controls included men with biochemical failure after local therapy on watchful waiting (n=10), as well as healthy controls (n=8). Global hemostasis was evaluated using the sensitive global hemostasis assay, thromboelastography (TEG). Patients were evaluated at baseline and every three months for a minimum of 12 months. Results: The results of the TEG studies demonstrated 14/18 (78%) of advanced PCa patients had evidence of a hypercoagulable state before initiating therapy. Significant baseline hypercoagulability was documented in this cohort compared to the two control groups. ADT did not appear to exacerbate hypercoagulability over time as a whole: only 10/18 (56%) patients had TEG findings consistent with hypercoagulability at the end of study. However, 3/18 (17%) PCa patients initiating ADT had significantly new hypercoagulable TEG changes on treatment compared to baseline. Conclusions: This prospective pilot study demonstrates a complex interaction between ADT and hypercoagulable state in men with advanced PCa. TEG abnormalities were mostly associated with volume of cancer as compared to ADT use; however, it is possible that ADT may lead to hypercoagulability in a subset of men, suggesting that sensitive monitoring of coagulation of men on ADT could help identify those at risk of developing CV/TE complications. Study limitations include the relatively small cohort of men followed after initiating ADT and these results require confirmation in a larger trial to rule out subtle effects on hypercoagulability.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effects of androgen-deprivation therapy on hypercoagulability in prostate cancer patients: A prospective, longitudinal study

Kaur¹,

Black

Robb

et al. 2017

CUAJ

Self Cite

View full text Add to dashboard Cite

show abstract

“…АЧТВ совсем не учитывает фибринолиз. Вероятно, по перечисленным причинам АЧТВ не имеет пред-сказательной силы тромботических осложнений у пациентов после операций [15,16], травм [17], с диабетом [18,19] и онкологическим заболевани-ем [20]. Данные в отношении беременности проти-воречивы [21,22].…”

Section: O N C O G E M a T O L O G Y 3 ' 2 0 1 5 V O L 10unclassified

“…В этой группе также наблюдали повышенное количество ТF, содер-жащих МВ. У 7 из 22 пациентов с гиперкоагуляцион-ной ТЭГ возникли тромботические осложнения, в то время как АЧТВ и МНО показывали норму [20]. ТЭГ также обнаруживала гиперкоагуляционное состо-яние у пациентов с раком молочной железы и колорек-тальным раком [53], опухолями желудочно-кишечного тракта, органов дыхания и другими опухолями [54], у пациентов после тромбоза глубоких вен (ТГВ) [55], но только не после церебрального венозного тромбоза [56].…”

Section: O N C O G E M a T O L O G Y 3 ' 2 0 1 5 V O L 10unclassified

Integrated laboratory coagulation tests in hypercoagulation diagnosis and thrombosis risk assessment. Part II. The sensitivity of integral tests to hypercoagulable states

Lipets¹,

Ataullakhanov²,

Panteleev³

2015

Onkogematologiâ

View full text Add to dashboard Cite

Assessing hypercoagulability and VTE risk using thromboelastography and Khorana score in women with cancers receiving chemotherapy

Tera,

Suh,

Fainchtein

et al. 2024

American J Hematol

Self Cite

View full text Add to dashboard Cite

Venous thromboembolism (VTE) is a common occurrence in cancer and chemotherapy increases thrombosis risk. Current risk assessment models such as the Khorana score (KS) and its modifications have limitations in female cancers. We assessed the coagulation profile of a group of women cancer patients under chemotherapy using thromboelastography (TEG) to determine if this can inform VTE risk assessment. Cancer patients who planned to receive chemotherapy were recruited. Baseline demographics, cancer data, BMI, Khorana Score (KS), and VTE risk factors were recorded and patients were followed for 6 months, for any thrombotic events. A total of 36 patients aged 35–85 (18 breast, 11 endometrial, 7 ovarian cancer) were evaluated. Hypercoagulability was detected in 63% of patients post‐chemo cycle 1 and 75% post‐cycle 2, with a significant increase in MA (maximum amplitude) and CI (clotting index), reduction in R (reaction time), K (clot kinetics), and LY30 (lysis time after 30 min of MA). KS showed only 7% of patients were high risk, 23% were low, and 70% were intermediate risk. MA and CI significantly increased in patients with intermediate and high‐risk KS when compared with the low‐risk patients and MA was positively correlated with KS. Five patients developed actual VTE; 100% of the tested ones were hypercoagulable either post‐cycle 1 or 2 and 80% were KS intermediate risk. TEG is a hypercoagulability marker and TEG‐MA and CI can potentially assess VTE risk. Larger studies are needed to assess the utility of TEG as an adjuvant to KS to better predict VTE in specific female cancers.

show abstract

Thromboelastography Identifies Hypercoagulablilty and Predicts Thromboembolic Complications in Patients with Prostate Cancer

Cited by 64 publications

References 38 publications

Effects of androgen-deprivation therapy on hypercoagulability in prostate cancer patients: A prospective, longitudinal study

Effects of androgen-deprivation therapy on hypercoagulability in prostate cancer patients: A prospective, longitudinal study

Integrated laboratory coagulation tests in hypercoagulation diagnosis and thrombosis risk assessment. Part II. The sensitivity of integral tests to hypercoagulable states

Assessing hypercoagulability and VTE risk using thromboelastography and Khorana score in women with cancers receiving chemotherapy

Contact Info

Product

Resources

About