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A Dangerous Partnership: Malignancy and Antiphospholipid Antibodies
Jozélio Freire de Carvalho1, Lara Ponte Amadei2, Carlos Ewerton Maia Rodrigues3
1Post-graduate Department, Institute of Health Sciences,Federal University of Bahia, Salvador, Brazil.
The Eurasian Journal of Medicine
|August 8, 2026
Summary
Malignancy is linked to antiphospholipid antibodies (aPL), increasing thrombosis risk. Careful interpretation of aPL profiles and persistence is crucial for cancer patients, as isolated positivity may not indicate antiphospholipid syndrome (APS).
Area of Science:
- Hematology
- Oncology
- Immunology
Background:
- Antiphospholipid syndrome (APS) involves antiphospholipid antibodies (aPL) and thrombosis/obstetric issues.
- Malignancies are prothrombotic, with emerging evidence of interactions with aPL.
- Interpreting aPL in cancer is complex due to varied study methodologies.
Purpose of the Study:
- To review current evidence on aPL in malignancy.
- Focus on prevalence, laboratory profiles, thrombosis, catastrophic APS (CAPS), and paraneoplastic associations.
- Clarify clinical implications for oncology patients.
Main Methods:
- Focused narrative review of PubMed/MEDLINE and PubMed Central.
- Search strategies emphasized antibody profile, persistence, tumor type, and thrombotic outcomes.
- Selection based on clinical relevance and verifiability; structured synthesis of findings.
Main Results:
- Increased anticardiolipin positivity noted in GI, genitourinary, and lung cancers.
- Lupus anticoagulant and anti-β2GPI findings were heterogeneous.
- Persistent or high-risk aPL profiles correlated with increased thrombosis in subgroups.
- CAPS and paraneoplastic APS reported in malignancy.
- Obstetric APS cohorts suggest a potential bidirectional link with cancer incidence.
Conclusions:
- The malignancy-aPL interaction involves increased antibody prevalence and phenotype-dependent thrombotic risk.
- CAPS and paraneoplastic mechanisms are associated with malignancy.
- Clinical interpretation requires considering antibody profile and persistence, not isolated positivity.
- Prospective studies are needed for clinical relevance and screening strategies.
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