The Hypercoagulable Profile of Patients with Bone Tumors: A Pilot Observational Study Using Rotational Thromboelastometry

Overview

Journal Cancers (Basel)

Publisher MDPI

Specialty Oncology

Date 2022 Aug 26

PMID 36010924

Authors

Andreas G Tsantes

Ilectra Loukopoulou

Dimitrios V Papadopoulos

Ioannis G Trikoupis

Anastasios G Roustemis

Stavros Goumenos

Rozeta Sokou

Konstantina A Tsante

Anastasios G Kriebardis

Panagiotis Koulouvaris

Dimitra Houhoula

Daniele Piovani

Panayiotis J Papagelopoulos

Stefanos Bonovas

Argirios E Tsantes

Affiliations

Soon will be listed here.

Abstract

Introduction: A detailed evaluation of the malignancy-associated coagulopathy (MAC) in surgical patients with bone tumors may allow for more effective thromboprophylactic measures. The purpose of this study was to assess the perioperative hemostatic changes in patients with bone tumors, using rotational thromboelastometry (ROTEM). Methods: An observational study was performed, including 50 patients with bone tumors who underwent oncologic resection and 30 healthy controls, matched for age and gender. The preoperative and postoperative laboratory evaluation of coagulation in both groups included conventional coagulation tests and a ROTEM analysis. The results of the conventional coagulation tests and the ROTEM analysis were compared between the two groups. Results: The results of the conventional coagulation tests were comparable between the tumor patients and the healthy controls. However, compared to the healthy adults, the tumor patients had lower CT (p < 0.001) and CFT (p < 0.001) values suggesting a rapid induction of the coagulation cascade, elevated A10 (p < 0.001) and MCF (p < 0.001) values indicating a higher clot strength and platelet activation, and elevated LI60 (p < 0.001) values indicating hypofibrinolysis in patients with bone tumors. The multiple linear regression analysis (controlling for potential confounding factors) confirmed the independent association of bone tumors with these hemostatic changes. Conclusions: Our results support the advantageous use of a ROTEM in patients with bone tumors over conventional coagulation tests because the qualitative changes in the hemostatic profile of these patients that can be detected by a ROTEM analysis cannot be identified by conventional tests. The ROTEM results indicate that the hypercoagulable state in patients with bone tumors is caused by the malignancy-associated activation of the coagulation cascade, platelet activation, and hypofibrinolysis.

Citing Articles

Cancer-Associated Thrombosis: Pathophysiology, Laboratory Assessment, and Current Guidelines.

Tsantes A, Petrou E, Tsante K, Sokou R, Frantzeskaki F, Domouchtsidou A Cancers (Basel). 2024; 16(11).

PMID: 38893201 PMC: 11171168. DOI: 10.3390/cancers16112082.

The Acute and Chronic Effects of Resistance and Aerobic Exercise in Hemostatic Balance: A Brief Review.

Skouras A, Antonakis-Karamintzas D, Tsantes A, Triantafyllou A, Papagiannis G, Tsolakis C Sports (Basel). 2023; 11(4).

PMID: 37104148 PMC: 10143125. DOI: 10.3390/sports11040074.

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