Coagulation Abnormalities and Oncology

• Coagulation Abnormalities and Oncology

AUTHOR(S)

Eckhardt PETRI

Clinical & Scientific Affairs, Dade Behring Marburg GmbH

SUMMARY

More than 100 years ago Trousseau described for the first time hemostatic abnormalities in stomach cancer. Many decades later in recognition of his work the stimulation of blood coagulation by tumors is still generally described as Trousseau's syndrome.

Three types of evidence support the idea of an important relationship between blood coagulation and tumor homeostasis: clinical, histologic, and pharmacologic.

Clinical and laboratory evidence is based on the well known phenomenon of patients with certain forms of cancer to develop thromboembolic disease and/or disseminated intra-vascular coagulation ( DIC ). Histologic evidence is provided by the observation of platelet and fibrin thrombi in vessels draining tumors. Finally the positive results of pharmacologic intervention with anticoagulant drugs and/or anti-platelet agents in animal tumor models and in human cancer have also supported the thesis that a " hypercoagulable " state associated with cancer is disadvantageous for the host. Today it is well accepted, that local or systemic activation of blood coagulation can be produced by tumor products, e.g. receptors, surface matrix, and cytokines. While this activation favors tumor spread, interruption of blood coagulation reactions, in general, favors the host and impairs tumor metastasis.

KEY WORDS

Cancer, D-dimer, Venous Thromboembolism