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

2.50
Hdl Handle:
http://hdl.handle.net/10541/66860
Title:
Early changes in the haemostatic and procoagulant systems after chemotherapy for breast cancer.
Authors:
Kirwan, C C; McDowell, G; McCollum, C N; Kumar, Shant; Byrne, Ged J
Abstract:
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.
Affiliation:
Department of Surgery, South Manchester University Hospitals Trust, Wythenshawe Hospital, Southmoor Road, Manchester M23 9LT, UK.
Citation:
Early changes in the haemostatic and procoagulant systems after chemotherapy for breast cancer. 2008, 99 (7):1000-6 Br. J. Cancer
Journal:
British Journal of Cancer
Issue Date:
7-Oct-2008
URI:
http://hdl.handle.net/10541/66860
DOI:
10.1038/sj.bjc.6604620
PubMed ID:
18766191
Type:
Article
Language:
en
ISSN:
1532-1827
Appears in Collections:
All Christie Publications ; Pathology

Full metadata record

DC FieldValue Language
dc.contributor.authorKirwan, C C-
dc.contributor.authorMcDowell, G-
dc.contributor.authorMcCollum, C N-
dc.contributor.authorKumar, Shant-
dc.contributor.authorByrne, Ged J-
dc.date.accessioned2009-05-01T10:33:29Z-
dc.date.available2009-05-01T10:33:29Z-
dc.date.issued2008-10-07-
dc.identifier.citationEarly changes in the haemostatic and procoagulant systems after chemotherapy for breast cancer. 2008, 99 (7):1000-6 Br. J. Canceren
dc.identifier.issn1532-1827-
dc.identifier.pmid18766191-
dc.identifier.doi10.1038/sj.bjc.6604620-
dc.identifier.urihttp://hdl.handle.net/10541/66860-
dc.description.abstractVenous 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.en
dc.language.isoenen
dc.subjectBreast Canceren
dc.subjectChemotherapyen
dc.subjectProcoagulantsen
dc.subject.meshAdult-
dc.subject.meshAged-
dc.subject.meshAntineoplastic Agents-
dc.subject.meshBlood Coagulation-
dc.subject.meshBreast Neoplasms-
dc.subject.meshCase-Control Studies-
dc.subject.meshFemale-
dc.subject.meshHemostasis-
dc.subject.meshHumans-
dc.subject.meshMiddle Aged-
dc.subject.meshVenous Thromboembolism-
dc.titleEarly changes in the haemostatic and procoagulant systems after chemotherapy for breast cancer.en
dc.typeArticleen
dc.contributor.departmentDepartment of Surgery, South Manchester University Hospitals Trust, Wythenshawe Hospital, Southmoor Road, Manchester M23 9LT, UK.en
dc.identifier.journalBritish Journal of Canceren

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