1. Predictors Of Cancer Associated Thrombosis
- Author
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Alfonso Tafur, George L. Dale, Suman Rathbun, Aaron S. Mansfield, Mohamad Cherry, Philip C. Comp, Jonathan Wren, and Julie Stoner
- Subjects
medicine.medical_specialty ,Aspirin ,medicine.drug_class ,business.industry ,Incidence (epidemiology) ,Immunology ,Low molecular weight heparin ,Cancer ,Cell Biology ,Hematology ,Odds ratio ,medicine.disease ,Biochemistry ,Chemotherapy regimen ,Internal medicine ,D-dimer ,medicine ,Mean platelet volume ,business ,medicine.drug - Abstract
Introduction Cancer associated thrombosis is the second most common cause of mortality among patients with malignancy. While preventive low molecular weight heparin is effective in preventing venous thromboembolism (VTE), lack of agreement on risk stratification methods have precluded its widespread use. The most studied VTE prediction tool is the Khorana score, but it does not capitalize on the use of novel biomarkers. We aimed to evaluate the value of biomarkers in prediction of VTE among patients with active cancer receiving outpatient chemotherapy. Methods We prospectively collected pre-chemotherapy blood samples on adult patients with solid organ tumors. We excluded patients on anticoagulation and those unable or unwilling to consent. Along with demographics and cancer specific variables, potential novel predictors of VTE were selected a priori and included: coated platelets (CP), D dimer (DD), protein C (PC), fibrin monomers (FM), mean platelet volume (MPV), platelet microparticles (PMP). Type of cancer was grouped according to the Khorana score (Very high risk: Stomach, Pancreas; High risk: Lung, Gynecologic, Bladder, Testicular; Low/Moderate risk: all other sites). VTE events were adjudicated at 6 months of follow up. For all statistical analyses we used SAS 9.2 (SAS Institute Inc., Cary, NC, USA). A p value of Results We have recruited a total of 101 patients (mean + standard deviation age 59.7+11 years, 68% female), 20% of the 75 patients with complete follow up have developed a VTE. We found no significant association between the incidence of VTE and age, gender, or baseline Khorana score. The variables associated with incident VTE were: BMI (odds ratio [OR] 8.5 for BMI Conclusion Pre Chemotherapy level of Protein C is a potential biomarker for the incidence of VTE. We confirm that cancer type and BMI are predictors of cancer associated VTE. In addition, lower BMI is not usually recognized as a potential predictor of VTE in other prediction scores. We were underpowered to detect differences in the VTE incidence according to Khorana score. Finally, aspirin may have a role in outpatient cancer associated VTE prevention and deserves further investigation. Disclosures: Tafur: Stago Diagnostica: Research Funding. Rathbun:Stago Diagnostica: Research Funding.
- Published
- 2013