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Thorax. Dec 1988; 43(12): 978–981.
PMCID: PMC461606

Abnormal haemostasis in small cell lung cancer.

Abstract

Disorders of haemostasis and altered platelet activity have been documented in patients with malignant disease but their relation to response to treatment and prognosis are not known. Thrombin activity (fibrinopeptide A (FpA), plasmin mediated fibrinolysis (B beta 15-42) antigen), and platelet alpha granule release (beta thromboglobulin) were studied in 37 patients with small cell lung cancer to find out whether these indices show a relationship to chemoresponse. There was evidence of considerably increased thrombin activity, with a median fibrinopeptide A concentration of 13.2 (normal less than 4) pmol/ml, but only modestly increased fibrinolysis, with a median B beta 14-42 antigen concentration of 5.6 (normal less than 3) pmol/ml. Thus the ratio of fibrinopeptide A to B beta 15-42 concentration (FpA:B beta) was raised, with a median value of 2.2 (normal less than 1.33). In addition, 57% of patients had increased platelet alpha granule release, the median beta thromboglobulin concentration being 50 (normal less than 50) ng/ml. There was a significant association between increased thrombin generation and lack of response to chemotherapy. Furthermore, non-responders had higher FpA:B beta ratios. The same haemostatic markers were studied in nine patients who have been in complete remission for at least two years after chemotherapy for small cell lung cancer. There was a significant difference in thrombin activity and also in the ratio of thrombin activity to lysis between the pretreatment group and the group of two year survivors. Lack of response to chemotherapy appears to be related to increased thrombin activity. Such an association has not previously been reported in patients with malignant disease.

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  • Sack GH, Jr, Levin J, Bell WR. Trousseau's syndrome and other manifestations of chronic disseminated coagulopathy in patients with neoplasms: clinical, pathophysiologic, and therapeutic features. Medicine (Baltimore) 1977 Jan;56(1):1–37. [PubMed]
  • Sun NC, McAfee WM, Hum GJ, Weiner JM. Hemostatic abnormalities in malignancy, a prospective study of one hundred eight patients. Part I. Coagulation studies. Am J Clin Pathol. 1979 Jan;71(1):10–16. [PubMed]
  • Miller SP, Sanchez-Avalos J, Stefanski T, Zuckerman L. Coagulation disorders in cancer. I. Clinical and laboratory studies. Cancer. 1967 Sep;20(9):1452–1465. [PubMed]
  • Rickles FR, Edwards RL, Barb C, Cronlund M. Abnormalities of blood coagulation in patients with cancer. Fibrinopeptide A generation and tumor growth. Cancer. 1983 Jan 15;51(2):301–307. [PubMed]
  • Peuscher FW, Cleton FJ, Armstrong L, Stoepman-van Dalen EA, van Mourik JA, van Aken WG. Significance of plasma fibrinopeptide A (fpA) in patients with malignancy. J Lab Clin Med. 1980 Jul;96(1):5–14. [PubMed]
  • Lyman GH, Bettigole RE, Robson E, Ambrus JL, Urban H. Fibrinogen kinetics in patients with neoplastic disease. Cancer. 1978 Mar;41(3):1113–1122. [PubMed]
  • Al-Mondhiry H. Disseminated intravascular coagulation: experience in a major cancer center. Thromb Diath Haemorrh. 1975 Sep 30;34(1):181–193. [PubMed]
  • Farrell RJ, Duffy MJ, Moriarty MJ, Duffy GJ. Plasma concentrations of the platelet-specific beta-thromboglobulin in malignant disease. Br J Cancer. 1980 Jun;41(6):989–991. [PMC free article] [PubMed]
  • Al-Mondhiry H. beta-Thromboglobulin and platelet-factor 4 in patients with cancer: correlation with the stage of disease and the effect of chemotherapy. Am J Hematol. 1983 Apr;14(2):105–111. [PubMed]
  • Kudryk B, Robinson D, Netré C, Hessel B, Blombäck M, Blombäck B. Measurement in human blood of fibrinogen/fibrin fragments containing the B beta 15-42 sequence. Thromb Res. 1982 Feb 1;25(3):277–291. [PubMed]
  • Zacharski LR, Henderson WG, Rickles FR, Forman WB, Cornell CJ, Jr, Forcier RJ, Harrower HW, Johnson RO. Rationale and experimental design for the VA Cooperative Study of Anticoagulation (Warfarin) in the Treatment of Cancer. Cancer. 1979 Aug;44(2):732–741. [PubMed]
  • Jamieson GA, Bastida E, Ordinas A. Mechanisms of platelet aggregation by human tumor cell lines. Prog Clin Biol Res. 1982;89:405–413. [PubMed]
  • Donati MB, Poggi A. Malignancy and haemostasis. Br J Haematol. 1980 Feb;44(2):173–182. [PubMed]
  • Gralnick HR, Abrell E. Studies of the procoagulant and fibrinolytic activity of promyelocytes in acute promyelocytic leukaemia. Br J Haematol. 1973 Jan;24(1):89–99. [PubMed]
  • Gralnick HR, Tan HK. Acute promyelocytic leukemia: a model for understanding the role of the malignant cell in hemostasis. Hum Pathol. 1974 Nov;5(6):661–673. [PubMed]
  • Al-Mondhiry H, McGarvey V, Leitzel K. Interaction of human tumor cells with human platelets and the coagulation system. Thromb Haemost. 1983 Oct 31;50(3):726–730. [PubMed]
  • Brown JM. A study of the mechanism by which anticoagulation with warfarin inhibits blood-borne metastases. Cancer Res. 1973 Jun;33(6):1217–1224. [PubMed]
  • Gasic GJ, Gasic TB, Murphy S. Anti-metastatic effect of aspirin. Lancet. 1972 Oct 28;2(7783):932–933. [PubMed]
  • Gasic GJ, Gasic TB, Galanti N, Johnson T, Murphy S. Platelet-tumor-cell interactions in mice. The role of platelets in the spread of malignant disease. Int J Cancer. 1973 May;11(3):704–718. [PubMed]
  • Gastpar H. Platelet-cancer cell interaction in metastasis formation: a possible therapeutic approcach to metastasis prophylaxis. J Med. 1977;8(2):103–114. [PubMed]
  • Zacharski LR, Henderson WG, Rickles FR, Forman WB, Cornell CJ, Jr, Forcier RJ, Edwards RL, Headley E, Kim SH, O'Donnell JF, et al. Effect of warfarin anticoagulation on survival in carcinoma of the lung, colon, head and neck, and prostate. Final report of VA Cooperative Study #75. Cancer. 1984 May 15;53(10):2046–2052. [PubMed]
  • Thornes RD. Oral anticoagulant therapy of human cancer. J Med. 1974;5(1):83–91. [PubMed]
  • Brugarolas A, Elias EG, Takita H, Mink IB, Mittelman A, Ambrus JL. Blood coagulation and fibrinolysis in patients with carcinoma of the lung. J Med. 1973;4(2):96–105. [PubMed]
  • Edwards RL, Rickles FR, Cronlund M. Abnormalities of blood coagulation in patients with cancer. Mononuclear cell tissue factor generation. J Lab Clin Med. 1981 Dec;98(6):917–928. [PubMed]
  • Jain R, Tabor DC, Engle JC. Plasma beta-thromboglobulin levels in lung cancer. South Med J. 1983 Nov;76(11):1380–1382. [PubMed]
  • Zacharski LR, Henderson WG, Rickles FR, Forman WB, Cornell CJ, Jr, Forcier RJ, Edwards R, Headley E, Kim SH, O'Donnell JR, et al. Effect of warfarin on survival in small cell carcinoma of the lung. Veterans Administration Study No. 75. JAMA. 1981 Feb 27;245(8):831–835. [PubMed]
  • Stanford CF. Anticoagulants in the treatment of small cell carcinoma of the bronchus. Thorax. 1979 Feb;34(1):113–116. [PMC free article] [PubMed]
  • Elias EG, Shukla SK, Mink IB. Heparin and chemotherapy in the management of inoperable lung carcinoma. Cancer. 1975 Jul;36(1):129–136. [PubMed]
  • Edlis HE, Goudsmit A, Brindley C, Niemetz J. Trial of heparin and cyclophosphamide (NSC-26271) in the treatment of lung cancer. Cancer Treat Rep. 1976 May;60(5):575–578. [PubMed]
  • Rohwedder JJ, Sagastume E. Heparin and polychemotherapy for treatment of lung cancer. Cancer Treat Rep. 1977 Oct;61(7):1399–1401. [PubMed]

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