M Pépin1,2, A Kleinjan3, D Hajage4,5, H R Büller3, M Di Nisio3,6, P W Kamphuisen7, L Salomon8, A Veyradier9,10,11, A Stepanian9,11, I Mahé1,10,11. 1. Service de Médecine Interne, Hôpital Louis Mourier (AP-HP), Colombes, France. 2. Unité 1176, INSERM, Le Kremlin-Bicêtre, France. 3. Department of Vascular Medicine, Academic Medical Center, Amsterdam, the Netherlands. 4. Département d'Epidémiologie et Recherche Clinique, URC Paris-Nord, Hôpital Bichat-Claude Bernard (AP-HP), Paris, France. 5. INSERM, CIC 1425-EC, UMR1123, Paris, France. 6. Department of Medical, Oral and Biotechnological Sciences, University G. D'Annunzio, Chieti, Italy. 7. Department of Vascular Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. 8. Département de Recherche, Centre Ophtalmologique Rothschild, Paris, France. 9. Service d'Hématologie biologique, Hôpital Lariboisière (AP-HP), Paris, France. 10. Universitaire Paris Diderot, EA 7334 REMES Sorbonne Paris Cité, Paris, France. 11. Université Paris Diderot, Institut Universitaire d'Hématologie, EA3518, Paris, France.
Abstract
UNLABELLED: ESSENTIALS: Cancer patients are at high risk of venous thromboembolism (VTE). In this study, cases and controls were cancer patients who did or did not develop VTE. von Willebrand factor (VWF) levels were higher if compared with controls and correlated with cancer stage. VWF and ADAMTS-13 are associated with the occurrence of VTE in cancer. BACKGROUND: Patients with cancer are at high risk of venous thromboembolism (VTE). ADAMTS-13 regulates von Willebrand factor (VWF) activity, which plays a role in the development of cancer and in VTE. OBJECTIVES: The aim of this study was to search for an association between the levels of VWF and ADAMTS-13 and VTE in patients with cancer and to compare current scoring systems for prediction of VTE before and after addition of these parameters. PATIENTS/ METHODS: In a case-control study, in which patients with recently diagnosed cancer were followed-up for 6 months, we compared 20 patients who developed VTE (cases) and 140 patients with cancer without VTE (controls), matched for sex, age, and type and stage of cancer. We measured VWF, ADAMTS-13 (activity and antigen), P-selectin, D-dimer and F1 + 2 levels at baseline, and calculated both the Khorana score and the Khorana score expanded after addition of P-selectin and D-dimer levels. RESULTS: VWF levels were significantly higher in cases when compared with controls (326 ± 185% vs. 242 ± 158%) and correlated with advanced stage of cancer: localized, 185 [142; 222]; locally advanced, 240 [146; 257]; metastatic, 267 [153; 324] (mean [interquartile range]). The addition of two biomarkers, ADAMTS-13 activity and F1 + 2 levels, to the Khorana score improved receiver operating curves. CONCLUSIONS: von Willebrand factor and ADAMTS-13 are associated with the occurrence of VTE in patients with cancer. Moreover, addition of ADAMTS-13 and F1 + 2 levels to the Khorana score considerably increases the predictive value for VTE.
UNLABELLED: ESSENTIALS: Cancerpatients are at high risk of venous thromboembolism (VTE). In this study, cases and controls were cancerpatients who did or did not develop VTE. von Willebrand factor (VWF) levels were higher if compared with controls and correlated with cancer stage. VWF and ADAMTS-13 are associated with the occurrence of VTE in cancer. BACKGROUND:Patients with cancer are at high risk of venous thromboembolism (VTE). ADAMTS-13 regulates von Willebrand factor (VWF) activity, which plays a role in the development of cancer and in VTE. OBJECTIVES: The aim of this study was to search for an association between the levels of VWF and ADAMTS-13 and VTE in patients with cancer and to compare current scoring systems for prediction of VTE before and after addition of these parameters. PATIENTS/ METHODS: In a case-control study, in which patients with recently diagnosed cancer were followed-up for 6 months, we compared 20 patients who developed VTE (cases) and 140 patients with cancer without VTE (controls), matched for sex, age, and type and stage of cancer. We measured VWF, ADAMTS-13 (activity and antigen), P-selectin, D-dimer and F1 + 2 levels at baseline, and calculated both the Khorana score and the Khorana score expanded after addition of P-selectin and D-dimer levels. RESULTS:VWF levels were significantly higher in cases when compared with controls (326 ± 185% vs. 242 ± 158%) and correlated with advanced stage of cancer: localized, 185 [142; 222]; locally advanced, 240 [146; 257]; metastatic, 267 [153; 324] (mean [interquartile range]). The addition of two biomarkers, ADAMTS-13 activity and F1 + 2 levels, to the Khorana score improved receiver operating curves. CONCLUSIONS:von Willebrand factor and ADAMTS-13 are associated with the occurrence of VTE in patients with cancer. Moreover, addition of ADAMTS-13 and F1 + 2 levels to the Khorana score considerably increases the predictive value for VTE.
Authors: Magnus S Edvardsen; Kristian Hindberg; Ellen-Sofie Hansen; Vânia M Morelli; Thor Ueland; Pål Aukrust; Sigrid K Brækkan; Line H Evensen; John-Bjarne Hansen Journal: Blood Adv Date: 2021-01-12
Authors: Hai-Jian Sun; Jian Chen; Hao Zhang; Bing Ni; Jennifer C van Velkinburgh; Yao Liu; Yu-Zhang Wu; Xia Yang Journal: Immunol Res Date: 2017-10 Impact factor: 2.829
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