Chemotherapy has been associated with an increased risk of venous thromboembolism (VTE). However, the prevalence of coagulation abnormalities or VTE occurrence as a consequence of different anti-cancer agents or treatment schemes is largely uncharacterized. Thus, this study was aimed at analyzing the impact of different anticancer drugs on the prothrombotic status of cancer out-patients scheduled for chemotherapy. To this purpose, a mono-institutional study was prospectively conducted to monitor serial changes of activated protein C (APC) function in 505 consecutive cancer out-patients with primary or relapsing solid cancer at the start of a new chemotherapy regimen. The results obtained showed that age >65 years (p = 0.01), ECOG performance status (p = 0.01), platinum-based (p = 0.035) and fluoropyrimidine-based regimens (p = 0.008) were independent predictors of an acquired APC resistance during the first chemotherapy cycle. Multivariate model of Cox proportional hazards survival analysis demonstrated that a decline in APC functionality (HR = 2.4; p = 0.013) and platinum-based regimens (HR = 2.2; p = 0.042) were both capable of predicting the occurrence of a first VTE episode during chemotherapy. Indeed, 14% of patients with platinum-associated APC impairment had VTE over a 1-year follow-up, compared to 3% of patients treated with other regimens and in whom APC functionality remained stable (HR = 1.5; p = 0.003). We may, thus, conclude that use of platinum-based regimens is responsible for induction of an acquired thrombophilic condition and represents a predictor for VTE even after adjustment for other risk factors.

Roselli, M., Ferroni, P., Riondino, S., Mariotti, S., Laudisi, A., Vergati, M., et al. (2013). Impact of chemotherapy on activated protein C-dependent thrombin generation--association with VTE occurrence. INTERNATIONAL JOURNAL OF CANCER, 133(5), 1253-1258 [10.1002/ijc.28104].

Impact of chemotherapy on activated protein C-dependent thrombin generation--association with VTE occurrence

ROSELLI, MARIO;Riondino, S;
2013-09-01

Abstract

Chemotherapy has been associated with an increased risk of venous thromboembolism (VTE). However, the prevalence of coagulation abnormalities or VTE occurrence as a consequence of different anti-cancer agents or treatment schemes is largely uncharacterized. Thus, this study was aimed at analyzing the impact of different anticancer drugs on the prothrombotic status of cancer out-patients scheduled for chemotherapy. To this purpose, a mono-institutional study was prospectively conducted to monitor serial changes of activated protein C (APC) function in 505 consecutive cancer out-patients with primary or relapsing solid cancer at the start of a new chemotherapy regimen. The results obtained showed that age >65 years (p = 0.01), ECOG performance status (p = 0.01), platinum-based (p = 0.035) and fluoropyrimidine-based regimens (p = 0.008) were independent predictors of an acquired APC resistance during the first chemotherapy cycle. Multivariate model of Cox proportional hazards survival analysis demonstrated that a decline in APC functionality (HR = 2.4; p = 0.013) and platinum-based regimens (HR = 2.2; p = 0.042) were both capable of predicting the occurrence of a first VTE episode during chemotherapy. Indeed, 14% of patients with platinum-associated APC impairment had VTE over a 1-year follow-up, compared to 3% of patients treated with other regimens and in whom APC functionality remained stable (HR = 1.5; p = 0.003). We may, thus, conclude that use of platinum-based regimens is responsible for induction of an acquired thrombophilic condition and represents a predictor for VTE even after adjustment for other risk factors.
1-set-2013
Pubblicato
Rilevanza internazionale
Articolo
Esperti anonimi
Settore MED/06 - ONCOLOGIA MEDICA
English
Con Impact Factor ISI
Thrombin; Antineoplastic Agents; Humans; thrombophilia; Aged; Venous Thromboembolism; chemotherapy; Prospective Studies; Protein C; Aged, 80 and over; Adult; Activated Protein C Resistance; Middle Aged; venous thromboembolism; Female; Male; Proportional Hazards Models
Roselli, M., Ferroni, P., Riondino, S., Mariotti, S., Laudisi, A., Vergati, M., et al. (2013). Impact of chemotherapy on activated protein C-dependent thrombin generation--association with VTE occurrence. INTERNATIONAL JOURNAL OF CANCER, 133(5), 1253-1258 [10.1002/ijc.28104].
Roselli, M; Ferroni, P; Riondino, S; Mariotti, S; Laudisi, A; Vergati, M; Cavaliere, F; Palmirotta, R; Guadagni, F
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/100158
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