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Related Experiment Videos

Abnormal haemostasis in small cell lung cancer.

R Milroy1, J T Douglas, J Campbell

  • 1Department of Respiratory Medicine, University Department of Medicine, Royal Infirmary, Glasgow.

Thorax
|December 1, 1988
PubMed
Summary

Increased thrombin activity and platelet activation are linked to poor chemotherapy response in small cell lung cancer patients. These hemostatic markers may predict treatment outcomes and prognosis in cancer patients.

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Area of Science:

  • Hematology
  • Oncology
  • Biochemistry

Background:

  • Disorders of hemostasis and platelet activity are observed in cancer patients.
  • The relationship between these hemostatic changes, treatment response, and prognosis in malignant diseases remains unclear.

Purpose of the Study:

  • To investigate the association between hemostatic markers and chemoresponse in small cell lung cancer (SCLC).
  • To determine if thrombin activity, fibrinolysis, and platelet alpha granule release correlate with treatment outcomes and prognosis in SCLC patients.

Main Methods:

  • Measured thrombin activity (fibrinopeptide A), fibrinolysis (B beta 15-42 antigen), and platelet alpha granule release (beta thromboglobulin) in 37 SCLC patients.
  • Analyzed the ratio of fibrinopeptide A to B beta 15-42 (FpA:B beta) and beta thromboglobulin levels.

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  • Compared these markers between pre-treatment patients, non-responders, and long-term survivors (2+ years complete remission).

    • Main Results:

    • Patients exhibited significantly increased thrombin activity (median FpA: 13.2 pmol/ml) and modestly increased fibrinolysis (median B beta 14-42: 5.6 pmol/ml), resulting in a raised FpA:B beta ratio (median 2.2).
    • 57% of patients showed increased platelet alpha granule release (median beta thromboglobulin: 50 ng/ml).
    • Increased thrombin generation and higher FpA:B beta ratios were significantly associated with lack of response to chemotherapy. Pre-treatment markers differed significantly between responders and non-responders, and between pre-treatment patients and long-term survivors.

    Conclusions:

    • Increased thrombin activity is strongly associated with lack of response to chemotherapy in small cell lung cancer.
    • Hemostatic markers, particularly elevated thrombin generation, may serve as predictors of poor treatment response and prognosis in SCLC.
    • This association between hemostasis and chemoresistance has not been previously reported in malignant diseases.