Assessment of coagulation parameters before and after cytotoxic therapy. a prospective study

Gilles Lugassy, M. Lichin

Research output: Contribution to journalArticlepeer-review

Abstract

Thromboembolism frequently occurs in cancer patients, and conveys a high morbidity and mortality. The thrombogenic effects of anticancer drugs have been shown in women with breast cancer, but have not been studied in hématologie patients receiving cytotoxic therapy. We conducted a prospective study of selected hemostatic parameters in a cohort of hemato-oncologic patients. Laboratory tests were repeated at the time of diagnosis, during chemotherapy, and after completion of at least 4 courses of treatment. Correlation with the occurrence of thromboembolic symptoms was also looked for. 53 patients were included in the study. A first group of 28 patients with CLL and low grade lymphoma received no therapy. A second, small group of 7 patients received oral therapy. The third group included 18 patients( 10 aggressive lymphomas, 6 Hodgkin lymphomas, 1 CLL, 1 myeloma) who received at least 4 courses of an anthracyclin containing regimen. All 18 patients were evaluated before therapy, after 2 and after 4 courses. None of the 53 patients developed symptoms of thromboembolic disorder during the study period of 6 months. Among the 28 untreated patients, 10 (35%) had elevated Protein C (PC) levels, 5(17,5%) had low Protein S(PS) levels, and 3(10%) had high Factor 12 levels. Elevated anticardiolipin antibodies were observed in 3 patients. All other examined parameters were normal: PT, PTT, Fibrinogen, D.Dimer, circulating anticoagulant, Antithrombine(AT), and APCR. In group 2 (7 patients) most parameters were normal, with pathological levels of PC, PS and AT in isolated patients. No changes were noted on repeated testing during therapy. In group 3, basic(pretherapy) levels of Factor 12 were decreased in 4 of 18 patients( 14%), elevated in 1. AT was low in2, PS low in 2 and elevated in 1 .PC levels were high in 5 patients(27%), and low in 2. After 2 courses of chemotherapy, levels of Factor 12 dropped by at least 30% in 4 patients(14%), as compared with pretherapy levels. AT levels dropped in 4 other patients, and PS in 3 patients. PC rose in6 patients (33%) and PS in another 3. These results were unchanged after 4 courses of therapy. Conclusions: Anthracyclin containing regimen do interfere with some elements of the coagulation system, especially Factor 12, PS, PC, AT, in a third of treated hématologie patients. The clinical importance of these findings is still to be determined.

Original languageEnglish GB
Pages (from-to)98b
JournalBlood
Volume96
Issue number11 PART II
StatePublished - 1 Dec 2000
Externally publishedYes

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

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