Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Dec 22:14:991.
doi: 10.1186/1471-2407-14-991.

Impact of breast cancer stage, time from diagnosis and chemotherapy on plasma and cellular biomarkers of hypercoagulability

Mourad Chaari, Ines Ayadi, Aurelie Rousseau, Eleftheria Lefkou, Patrick Van Dreden, Fatoumata Sidibe, Hela Ketatni, Vassiliki Galea, Amir Khaterchi, Racem Bouzguenda, Mounir Frikha, Lilia Ghorbal, Jamel Daoud, Choumous Kallel, Martin Quinn, Joseph Gligorov, Jean Pierre Lotz, Mohamed Hatmi, Ismail Elalamy, Grigoris T Gerotziafas  1
Affiliations

Impact of breast cancer stage, time from diagnosis and chemotherapy on plasma and cellular biomarkers of hypercoagulability

Mourad Chaari et al. BMC Cancer. .

Abstract

Background: In breast cancer patients routine thromboprophylaxis is not recommended but individualized risk assessment is encouraged. The incorporation of hypercoagulability biomarkers could increase the sensitivity of risk assessment models (RAM) to identify patients at VTE risk. To this aim we investigated the impact of cancer-related characteristics on hypercoagulability biomarkers.

Methods: Thrombin generation (TG) assessed with the Thrombogramme-Thrombinoscope®, levels of platelet derived microparticles (Pd-MP) assessed with flow cytometry, procoagulant phospholid dependent clotting time (PPL-ct) measured with a clotting assay and D-Dimers (were assessed in a cohort of 62 women with breast cancer and in 30 age matched healthy women.

Results: Patients showed significantly higher TG, Pd-MP, D-Dimers levels and shortened PPL-ct compared to the controls. The PPL-ct was inversely correlated with the levels of Pd-MP, which were increased in 97% of patients. TG and D-Dimers were increased in 76% and 59% of patients respectively. In any stage of the disease TG was significantly increased as compared to the controls. There was no significant difference of TG in patients with local, regional of metastatic stage. There was no significant difference in Pd-MP or Pd-MP/PS+ between the subgroups of patients with local or regional stage of cancer. Patients with metastatic disease had significantly higher levels of Pd-MP and Pd-MP/PS+ compared to those with regional stage. The D-Dimers increased in patients with metastatic stage. In patients on chemotherapy with less than 6 months since diagnosis TG was significantly higher compared to those on chemotherapy who diagnosed in interval > 6 months. Patients with metastatic disease had significantly higher levels of Pd-MP and D-Dimers compared to those with non-metastatic disease.

Conclusion: In breast cancer patients the stage, the time elapsed since the diagnosis and the administration of chemotherapy are determinants of cellular and plasma hypercoagulability. The levels and the procoagulant activity of Pd-MP are interconnected with the biological activity and the overall burden of cancer. TG reflects the procoagulant properties of both breast cancer and chemotherapy in the initial period of cancer diagnosis. Thus the weighted incorporation of the biomarkers of cellular and plasma hypercoagulabilty in RAM for VTE might improve their predictive value.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Distribution of individual values of thrombin generation rate (frame A), Peak of thrombin (frame B) and ETP (frame C) in the control group (open cycles) and in the group of patients (dark cycles).
Figure 2
Figure 2
Representative thrombograms from a healthy individual (a) and four patients with high thrombin generation (b, c, d, e).
Figure 3
Figure 3
Impact of the interval since the diagnosis (shorter of longer than 6 months) on the ETP in patients on chemotherapy.
Figure 4
Figure 4
Impact of the stage of breast cancer on the conentration of D-Dimers.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Trousseau A. Phlegmasia Alba Dolens. In: Trousseau A, editor. Clinique Medicale de l’Hotel Dieu de Paris. Paris: Ballier; 1865. pp. 654–712.
    1. Boulliaud M. De l’oblitération des veins et de son influence sur la formation des hydropisies partielles. Arch Gen Med. 1823;1:188–204.
    1. Illtyd J, Matheson N. Thrombophlebitis in Cancer. The Practitioner. 1935.
    1. Heit JA, Mohr DN, Silverstein MD, Petterson TM, O'Fallon WM, Melton LJ., III Predictors of recurrence after deep vein thrombosis and pulmonary embolism: a population-based cohort study. Arch Intern Med. 2000;160:761–768. doi: 10.1001/archinte.160.6.761. - DOI - PubMed
    1. Blom JW, Doggen CJ, Osanto S, Rosendaal FR. Malignancies, prothrombotic mutations, and the risk of venous thrombosis. JAMA. 2005;293:715–722. doi: 10.1001/jama.293.6.715. - DOI - PubMed
Pre-publication history
    1. The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2407/14/991/prepub