Abstract Number: PB0371
Meeting: ISTH 2020 Congress
Theme: Coagulation and Natural Anticoagulants » Microparticles
Background: Cancer causes a hypercoagulable state and thus a high risk for thrombosis. Extracellular vesicles (EV) are elevated in colorectal cancer (CRC) patients and affect coagulation activation by exposing tissue factor (TF) and phospholipids.
Aims: We aimed to evaluate the long-term effects of chemotherapy on number and origin of EV and coagulation activation.
Methods: We included patients with advanced CRC receiving 5-fluorouracilbased chemotherapy. The number of EV was assessed by flow cytometry in fresh platelet poor plasma obtained immediately before chemotherapy. EV were defined by size (forward scatter, < 1 µm) and annexin V binding and labeled using antibodies to categorize EV origin (anti-CD41a: platelet EV [PLT+EV]; anti-CD142: TF EV [TF+EV]). Additionally, D-Dimer, peak thrombin and CEA was determined. The paired t-test was used to compare baseline levels with levels obtained before chemotherapy. Data are given in absolute numbers (median [quartiles]) if not stated otherwise.
Results: 51 patients (mean age 63 years, 76% men) were enrolled. Table 1 shows the number of EV, EV sub-species, levels of D-dimer, peak thrombin and CEA at baseline and before 2nd, 3rd, 4th, and 5thchemotherapy, respectively. EV significantly decreased from 372 (277; 617)x103 mL-1at baseline to 270 (184; 486)x103 mL-1before the 3rdcycle. PLT+EV significantly decreased from 175 (126; 351)x103 mL-1 at baseline to 125 (74; 208)x103 mL-1before the 3rdcycle. The proportion of PLT+EV was about 50% throughout chemotherapy. Number and proportion of TF+EV were small at all time points. D-dimer levels were 1.07 (0.54; 2.73) µg mL-1 at baseline and remained stable. Peak thrombin was higher at each timepoint when compared to baseline levels. CEA decreased throughout chemotherapy.
Conclusions: In patients with advanced CRC, chemotherapy attenuates EV generation and affects coagulation activation as indicated by an increase of peak thrombin levels.
Before 1st ChTx | Before 2nd ChTx | p-value 1st vs 2nd | Before 3rd ChTx | p-value 1st vs 3rd | Before 4th ChTx | p-value 1st vs 4th | Before 5th ChTx | p-value 1st vs 5th | |
n | 51 | 50 | 48 | 35 | 29 | ||||
EV (x 103 mL-1) | 372 (277; 617) | 348 (220; 520) | 0.12 | 270 (184; 486) | 0.04 | 318 (207; 435) | 0.16 | 378 (204; 583) | 0.48 |
PLT+EV (x 103 mL-1) | 175 (126; 351) | 172 (100; 248) | 0.02 | 125 (74; 208) | 0.002 | 143 (80; 210) | 0.03 | 106 (77; 254) | 0.04 |
Proportion (%) of EV | 47 | 49 | 46 | 45 | 28 | ||||
TF+EV (x 103 mL-1) | 14 (8; 35) | 15 (9; 31) | 0.7 | 11 (7; 26) | 0.06 | 12 (9; 26) | 0.05 | 13 (8; 23) | 0.2 |
Proportion (%) of EV | 4 | 4 | 4 | 4 | 3 | ||||
D-Dimer (µg mL-1) | 1.07 (0.54; 2.73) | 0.96 (0.56; 2.65) | 0.9 | 1.03 (0.52; 1.98) | 0.6 | 0.86 (0.49; 2.20) | 0.1 | 0.77 (0.59; 1.49) | 0.3 |
Peak thrombin (nM) | 152.8 (73.7; 208.1) | 180.5 (19.1; 239.6) | 0.023 | 181.1 (135.3; 217.1) | 0.011 | 172.2 (139.2; 214.35) | 0.21 | 177,7 (118.3; 263.7) | 0.16 |
CEA (µg L-1) | 12.5 (2.9; 95.1) | 11.1 (3.9; 70.6) | 0.09 | 8.3 (2.4; 52.1) | 0.11 | 9.3 (3.3; 24.7) | 0.09 | 5.9 (3.1; 20.1) | 0.09 |
[Number of extracellular vesicles (EV), levels of D-dimer, peak thrombin, and CEA in colorectal cancer patients before and during chemotherapy]
To cite this abstract in AMA style:
Traby L, Puhr HC, Kollars M, Steinbrecher O, Prager G, Scheithauer W, Kornek G, Kyrle PA, Eichinger S. Effects of Chemotherapy on Extracellular Vesicles and Coagulation Activation in Advanced Colorectal Cancer Patients [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/effects-of-chemotherapy-on-extracellular-vesicles-and-coagulation-activation-in-advanced-colorectal-cancer-patients/. Accessed May 1, 2024.« Back to ISTH 2020 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/effects-of-chemotherapy-on-extracellular-vesicles-and-coagulation-activation-in-advanced-colorectal-cancer-patients/