Reactive thrombocytosis might contribute to chemotherapy-related thrombophilia in patients with lung cancer

Gabriella Zecchina, Paolo Ghio, Sandra Bosio, Marta Cravino, Clara Camaschella, Giorgio V. Scagliotti

Research output: Contribution to journalArticle

Abstract

PURPOSE: Thrombotic risk is increased in patients with cancer and further potentiated by chemotherapy. We assessed whether early hemostatic alterations could represent a risk factor for thrombosis in patients undergoing chemotherapy for lung cancer. PATIENTS AND METHODS: Forty-nine patients receiving chemotherapy for unresectable, locally advanced, or metastatic lung cancer were included. Blood cell count, prothrombin time, partial thromboplastin time, fibrinogen, antithrombin, D-dimers, protein C, protein S, homocysteine, folates, vitamin B 12, and activated protein-C resistance were measured at day 0, +7, +15, and +21 of the first chemotherapy cycle. Factor V Leiden and FII G20210A mutations were assessed. Follow-up of patients was prospectively performed for thrombosis during all chemotherapy treatment. Factor V Leiden and FII G20210A frequency were the same as in controls. RESULTS: Average basal levels of prothrombin time, partial thromboplastin time, antithrombin, protein C, protein S, folates, vitamin B 12, and activated protein-C resistance were normal and remained stable during chemotherapy. Homocysteine, D-dimers, and fibrinogen basal levels were high but remained constant after chemotherapy. An average reduction in platelet count was recorded at day +14 in all patients after a striking increase (5.2-fold) at day +21 in the group of patients treated with gemcitabine (P <0.001). Four thrombotic events were recorded. In all cases, thrombosis occurred within 10 days of the second or the following chemotherapy cycle with gemcitabine and cisplatin. One patient had Factor V Leiden heterozygous disease. CONCLUSION: Our findings exclude alterations of coagulation inhibitors or activation of difused intravascular coagulation/fibrinolysis as factors that induce chemotherapy-related thrombosis in lung cancer. The temporal relationship between thrombocytosis at the time of chemotherapy administration and the clinical onset of thrombotic events suggests that thrombocytosis plays a role in triggering thrombotic complications.

Original languageEnglish
Pages (from-to)264-267
Number of pages4
JournalClinical Lung Cancer
Volume8
Issue number4
DOIs
Publication statusPublished - Jan 2007

Keywords

  • Hemostatic alterations
  • Hemostatic factors
  • Thrombosis

ASJC Scopus subject areas

  • Cancer Research
  • Pulmonary and Respiratory Medicine

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    Zecchina, G., Ghio, P., Bosio, S., Cravino, M., Camaschella, C., & Scagliotti, G. V. (2007). Reactive thrombocytosis might contribute to chemotherapy-related thrombophilia in patients with lung cancer. Clinical Lung Cancer, 8(4), 264-267. https://doi.org/10.3816/CLC.2007.n.004