Cargando…

Early changes in the haemostatic and procoagulant systems after chemotherapy for breast cancer

Venous thromboembolism (VTE) following breast cancer chemotherapy is common. Chemotherapy-induced alterations in markers of haemostasis occur during chemotherapy. It is unclear how rapidly this occurs, whether this is upregulated in patients developing VTE and whether changes predict for VTE. Marker...

Descripción completa

Detalles Bibliográficos
Autores principales: Kirwan, C C, McDowell, G, McCollum, C N, Kumar, S, Byrne, G J
Formato: Texto
Lenguaje:English
Publicado: Nature Publishing Group 2008
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2567096/
https://www.ncbi.nlm.nih.gov/pubmed/18766191
http://dx.doi.org/10.1038/sj.bjc.6604620
_version_ 1782159993549619200
author Kirwan, C C
McDowell, G
McCollum, C N
Kumar, S
Byrne, G J
author_facet Kirwan, C C
McDowell, G
McCollum, C N
Kumar, S
Byrne, G J
author_sort Kirwan, C C
collection PubMed
description Venous thromboembolism (VTE) following breast cancer chemotherapy is common. Chemotherapy-induced alterations in markers of haemostasis occur during chemotherapy. It is unclear how rapidly this occurs, whether this is upregulated in patients developing VTE and whether changes predict for VTE. Markers of haemostasis, functional clotting assays and vascular endothelial growth factor were measured before chemotherapy and at 24 h, 4 days, 8 days and 3 months following commencement of chemotherapy in early and advanced breast cancer patients and in age- and sex-matched controls. Duplex ultrasound imaging was performed after 1 month or if symptomatic. Of 123 patients, 9.8% developed VTE within 3 months. Activated partial thromboplastin time (APTT), prothrombin time (PT), D-dimer, fibrinogen, platelet count, VEGF and fibrinogen were increased in cancer. Fibrinogen, D-dimer, VEGF and tissue factor were increased, at baseline, in patients subsequently developing VTE. D-dimer of less than 500 ng ml(−1) has a negative predictive value of 97%. Activated partial thromboplastin time, PT and thrombin–antithrombin showed significantly different trends, as early as within 24 h, in response to chemotherapy in patients subsequently developing VTE. Markers of coagulation and procoagulants are increased, before chemotherapy, in patients who subsequently develop VTE. A group of patients at minimal risk of VTE can be identified, allowing targeted thrombopropylaxis to the higher risk group.
format Text
id pubmed-2567096
institution National Center for Biotechnology Information
language English
publishDate 2008
publisher Nature Publishing Group
record_format MEDLINE/PubMed
spelling pubmed-25670962009-10-07 Early changes in the haemostatic and procoagulant systems after chemotherapy for breast cancer Kirwan, C C McDowell, G McCollum, C N Kumar, S Byrne, G J Br J Cancer Clinical Study Venous thromboembolism (VTE) following breast cancer chemotherapy is common. Chemotherapy-induced alterations in markers of haemostasis occur during chemotherapy. It is unclear how rapidly this occurs, whether this is upregulated in patients developing VTE and whether changes predict for VTE. Markers of haemostasis, functional clotting assays and vascular endothelial growth factor were measured before chemotherapy and at 24 h, 4 days, 8 days and 3 months following commencement of chemotherapy in early and advanced breast cancer patients and in age- and sex-matched controls. Duplex ultrasound imaging was performed after 1 month or if symptomatic. Of 123 patients, 9.8% developed VTE within 3 months. Activated partial thromboplastin time (APTT), prothrombin time (PT), D-dimer, fibrinogen, platelet count, VEGF and fibrinogen were increased in cancer. Fibrinogen, D-dimer, VEGF and tissue factor were increased, at baseline, in patients subsequently developing VTE. D-dimer of less than 500 ng ml(−1) has a negative predictive value of 97%. Activated partial thromboplastin time, PT and thrombin–antithrombin showed significantly different trends, as early as within 24 h, in response to chemotherapy in patients subsequently developing VTE. Markers of coagulation and procoagulants are increased, before chemotherapy, in patients who subsequently develop VTE. A group of patients at minimal risk of VTE can be identified, allowing targeted thrombopropylaxis to the higher risk group. Nature Publishing Group 2008-10-07 2008-09-02 /pmc/articles/PMC2567096/ /pubmed/18766191 http://dx.doi.org/10.1038/sj.bjc.6604620 Text en Copyright © 2008 Cancer Research UK https://creativecommons.org/licenses/by/4.0/This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material.If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit https://creativecommons.org/licenses/by/4.0/.
spellingShingle Clinical Study
Kirwan, C C
McDowell, G
McCollum, C N
Kumar, S
Byrne, G J
Early changes in the haemostatic and procoagulant systems after chemotherapy for breast cancer
title Early changes in the haemostatic and procoagulant systems after chemotherapy for breast cancer
title_full Early changes in the haemostatic and procoagulant systems after chemotherapy for breast cancer
title_fullStr Early changes in the haemostatic and procoagulant systems after chemotherapy for breast cancer
title_full_unstemmed Early changes in the haemostatic and procoagulant systems after chemotherapy for breast cancer
title_short Early changes in the haemostatic and procoagulant systems after chemotherapy for breast cancer
title_sort early changes in the haemostatic and procoagulant systems after chemotherapy for breast cancer
topic Clinical Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2567096/
https://www.ncbi.nlm.nih.gov/pubmed/18766191
http://dx.doi.org/10.1038/sj.bjc.6604620
work_keys_str_mv AT kirwancc earlychangesinthehaemostaticandprocoagulantsystemsafterchemotherapyforbreastcancer
AT mcdowellg earlychangesinthehaemostaticandprocoagulantsystemsafterchemotherapyforbreastcancer
AT mccollumcn earlychangesinthehaemostaticandprocoagulantsystemsafterchemotherapyforbreastcancer
AT kumars earlychangesinthehaemostaticandprocoagulantsystemsafterchemotherapyforbreastcancer
AT byrnegj earlychangesinthehaemostaticandprocoagulantsystemsafterchemotherapyforbreastcancer