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The course of fibrinolytic proteins in children with malignant bone tumours

U Nowak-Göttl1, N Münchow, U Klippel

  • 1Paediatric Haematology/Oncology, University Hospital, Münster, Germany.

European Journal of Pediatrics
|January 29, 2000
PubMed

Insights

This study investigated fibrinolytic proteins in children with Ewing sarcoma (ES) and osteosarcoma (OS). Elevated urokinase plasminogen activator (u-PA) may indicate poorer outcomes in ES patients, warranting further research.

Area of Science:

  • Oncology
  • Hematology
  • Biochemistry

Background:

  • Fibrinolytic and proteolytic proteins play roles in cancer progression and complications.
  • Understanding these roles in pediatric bone cancers like Ewing sarcoma (ES) and osteosarcoma (OS) is crucial for improving patient outcomes.

Purpose of the Study:

  • To evaluate the role of fibrinolytic and proteolytic proteins in pediatric ES and OS patients.
  • To assess the relationship between these proteins, postoperative complications, and long-term outcomes.
  • To investigate the impact of low-molecular-weight heparin (LMWH) prophylaxis.

Main Methods:

  • Prospective, two-arm, two-center study involving 75 children and adolescents with ES or OS.
  • Measurement of plasminogen, PAI-1, t-PA, u-PA, Factor V Q506 mutation, protein C, protein S, antithrombin, and lipoprotein (a).
  • All patients received LMWH prophylaxis for 6 weeks to 3 months.

Main Results:

  • No thromboembolic complications were observed in patients receiving LMWH, even with prothrombotic risk factors.
  • Elevated urokinase plasminogen activator (u-PA) concentrations were found in 5 out of 7 relapsed ES patients prior to initial tumor therapy.
  • No significant differences in PAI-1 or t-PA antigen levels were noted between relapsed and non-relapsed groups.

Conclusions:

  • Low-molecular-weight heparin (LMWH) appears safe and effective in preventing thromboembolic events in this cohort.
  • Elevated u-PA may serve as a potential prognostic marker for poorer outcomes in pediatric Ewing sarcoma.
  • Further prospective multicenter studies are recommended to validate the role of u-PA in ES.
Abstract

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