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Thrombosis and coagulation abnormalities associated with cancer
1Vanderbilt University Medical Center, Nashville, TN 37232.
Annals of Clinical and Laboratory Science
|January 1, 1994
Summary
Malignancy-associated thrombosis, including portal vein thrombosis in a myeloproliferative disorder case, highlights coagulation and platelet abnormalities. Laboratory assessment aids in understanding these complex hemostatic changes in cancer patients.
Area of Science:
- Hematology
- Oncology
- Clinical Pathology
Background:
- Hemostasis abnormalities and malignancy are historically linked, with up to 60% of cancer patients experiencing thrombosis.
- Commonly observed changes include decreased coagulation factors, circulating anticoagulants, and altered platelet counts and function.
Observation:
- This work presents a case of portal vein thrombosis in a 59-year-old woman diagnosed with a myeloproliferative disorder.
- The patient's condition was initially diagnosed as septic portal vein thrombosis but was found to be secondary to the myeloproliferative disorder.
Findings:
- Hypercoagulable states in neoplasms can be linked to deficiencies in anticoagulants like antithrombin III, protein C, and protein S.
- Elevated coagulation factors (I, V, VIII:C, IX, XI) and increased platelet turnover are implicated in malignancy-associated hypercoagulability.
- Monitoring thrombus lysis involves tracking fibrin degradation products, D-dimer, fibrinopeptides, and platelet factor IV, alongside decreased coagulation inhibitors.
Implications:
- These hemostatic changes can lead to a state of disseminated intravascular coagulopathy, increasing the risk of thrombus formation over hemorrhage.
- Understanding these abnormalities is crucial for effective clinical laboratory assessment and patient management in oncology and hematology.