Abstract Number: PB2173
Meeting: ISTH 2020 Congress
Theme: Venous Thromboembolism and Cardioembolism » Cancer Associated Thrombosis
Background: Cancer has the ability to alter all mechanisms linked to the hemostatic system, and therefore, venous thromboembolism (VTE) is a frequent complication in these patients. Until the present, no study has evaluated the fibrinolytic potential by the method of simultaneous thrombin and plasmin generation (STP) on this setting.
Aims: Evaluate the fibrinolytic activity of patients with cancer, in the absence and presence of VTE, using the STP method.
Methods: A multicenter prospective study to assess the development of VTE in all cancer patients is underway on Unicamp, SP, Brazil. The global fibrinolytic capacity was assessed using the simultaneous thrombin and plasmin generation assay by fluorometric methodology.
Results: One hundred thirteen patients with newly diagnosed cancer without chemotherapy and 31 healthy individuals were included. During the six-months follow-up eleven patients developed VTE (CAT). The median age with and without DVT was 58 (19 – 90) and 53 (31 – 78) years, respectively. The male was predominant among CAT patients (54.54%). The Lymphoma/Myeloma were more prevalent in our study population (57.84%) and among CAT patients were Brain, Stomach and Pancreas cancer subtypes. The results of four parameters from the curve of plasmin and thrombin generation are in table1. Cancer patients showed a shorter lag time and a higher thrombin production speed, but the concentration of thrombin generated was similar between the groups (Figure 1). The plasmin concentration generated was lower in cancer patients, accompanied by an early lag time. In addition, plasmin production speed was shown to be more accelerated in patients who developed thrombosis when compared to those who did not.
Conclusions: Cancer patients showed a state of hypercoagulability, characterized by a fast thrombin generation without increased concentration. The lower production of plasmin and hypofibrinolysis in cancer patients can contribute to VTE risk.
| Parameters | Healthy Controls | Cancer Patients | CAT Patients | P-Value |
| MA – Thrombin | 863.48 (441.15 – 1021.15) | 866.43 (98.85 – 1440.35) | 877.51 (119.60 – 1064.35) | 0.4358 |
| Time to MA (min) – Thrombin | 39,24 (15.75 – 216.75) | 23.48 (6.75 – 235.50) | 16.77 (6.75 – 31.50) | <0.0001 |
| Vmax (AU/min) – Thrombin | 266.81 (131.80 – 461.8) | 390.30 (22.13 – 789.53) | 292.16 (19.17 – 560.53) | <0.0001 |
| Lag time – Thrombin | 8.71 (4.50 – 12.75) | 13.57 (0 – 239.25) | 45.95 (0 – 240.0) | <0.0001 |
| MA – Plasmin | 772.99 (630.50 – 977.75) | 666.21 (38.10-1155.80) | 632.45 (40.20 – 977.65) | 0.0016 |
| Time to MA (min) – Plasmin | 149.36 (86.25 – 240.0) | 141.21 (78.75 – 240.00) | 164.25 (0.75 – 237.75) | 0.0691 |
| Vmax (AU/min) – Plasmin | 30.34 (1.53 – 56.67) | 24.27 (2.09 – 51.07) | 49.65 (5.80 – 288.14) | 0.0175 |
| Lag time – Plasmin | 23.06 (14.24 – 33.75) | 17.85 (1.50 – 60.0) | 48.68 (9.75 – 239.25) | <0.0001 |
[Table 1. Comparison of parameters between cancer patients (n=102), CAT patients (n=11) and healthy controls (n=31).]
[Figure 1. Comparison of thrombin and plasmin generation between cancer patients (n=102), CAT Patients (n=11) and healthy controls (n=31).]
To cite this abstract in AMA style:
da Silva Souza Gois G, Evelyn Alves de Almeida M, Ramires Rodrigues Alencar T, Aparecida de Lima Montalvão S, Moraes Martinelli B, Macedo Toni I, Barreto Carvalheira J, Adami Andreollo N, Etchebehere M, Cesar Teixeira J, Maria Annichino-Bizzacchi J, ADVENTH Cancer Investigators . Cancer Patients Has Lower Plasmin Generation by Simultaneous Thrombin and Plasmin Assay Evaluation [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/cancer-patients-has-lower-plasmin-generation-by-simultaneous-thrombin-and-plasmin-assay-evaluation/. Accessed September 27, 2023.« Back to ISTH 2020 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/cancer-patients-has-lower-plasmin-generation-by-simultaneous-thrombin-and-plasmin-assay-evaluation/