Advanced prostate cancer activates coagulation: a controlled study of activation markers of coagulation in ambulatory patients with localized and advanced prostate cancer

Cancer and increased age are risk factors for coagulation activation. Patients with advanced prostate cancer, which usually presents in the seventh to eighth decade of life, are likely to be at increased risk for thrombosis. We report results of a controlled study of changes in specific and sensitive markers of coagulation activation in patients with prostate cancer. Complete blood count, prothrombin time, partial thromboplastin time, prothrombin fragment 1 + 2 (F1 + 2), thrombin–antithrombin complex (TAT) and quantitative D-dimers (DD) were measured in 30 patients of advanced prostate cancer (androgen ablated), in 30 newly diagnosed localized prostate cancer patients, in 30 healthy age-matched volunteers, and in 20 healthy young volunteers. Plasma F1 + 2 (P < 0.05) and DD (P < 0.05), but not TAT, were significantly elevated in healthy elderly males (mean age, 77 years) when compared with healthy young volunteers (mean age, 35 years). F1 + 2, TAT and DD were significantly elevated in advanced prostate cancer when compared with healthy age-matched controls (P < 0.001). In conclusion, advanced prostate cancer patients have significantly increased levels of sensitive markers of coagulation activation compared with healthy age-matched controls. This data can be used to plan studies to determine the risk of clinically significant coagulopathy and the role of primary prophylaxis in patients with advanced prostate cancer.

[1]  M. Samama,et al.  Laboratory Diagnosis of the Thrombophilic State in Cancer Patients , 1999, Seminars in thrombosis and hemostasis.

[2]  J. Paramo,et al.  Measurement of prethrombotic markers in the assessment of acquired hypercoagulable states. , 1999, Thrombosis research.

[3]  M. Cortellaro,et al.  Clinical Utility of Prothrombin Fragment 1+2, Thrombin Antithrombin III Complexes and D-dimer Measurements in the Diagnosis of Deep Vein Thrombosis following Total Hip Replacement , 1998, Thrombosis and Haemostasis.

[4]  A. Gadducci,et al.  Prothrombin fragment F1+2 and thrombin-antithrombin III complex (TAT) plasma levels in patients with gynecological cancer. , 1996, Gynecologic oncology.

[5]  P M Mannucci,et al.  Hypercoagulability in centenarians: the paradox of successful aging. , 1995, Blood.

[6]  B. Boneu,et al.  Prothrombin fragment 1 + 2, thrombin–antithrombin III complexes and D‐dimers in acute deep vein thrombosis: effects of heparin treatment , 1991, British journal of haematology.

[7]  J. Hirsh,et al.  The thrombogenic effect of anticancer drug therapy in women with stage II breast cancer. , 1988, The New England journal of medicine.

[8]  P. Vokonas,et al.  Aging-associated changes in indices of thrombin generation and protein C activation in humans. Normative Aging Study. , 1987, The Journal of clinical investigation.

[9]  H. Saito,et al.  Increased incidence of thromboembolism in stage IV breast cancer patients treated with a five‐drug chemotherapy regimen , 1984, Cancer.

[10]  R Denis,et al.  [Survival of patients with cancer of the prostate]. , 1972, Journal d'urologie et de nephrologie.

[11]  J. V. van Wersch,et al.  Coagulation and Fibrinolysis Activation Markers in Prostatic Carcinoma Patients , 1997, European journal of clinical chemistry and clinical biochemistry : journal of the Forum of European Clinical Chemistry Societies.

[12]  C. Caulin,et al.  Prevention of deep vein thrombosis in elderly medical in-patients by a low molecular weight heparin: a randomized double-blind trial. , 1986, Haemostasis.