Background: The prevalence of thrombosis in lymphoma patients is reportedly high and ranges from 3 – 10%, and further increased at advanced stages of the disease especially in hgNHL. The thrombin generation potential in these patients is decreased.
Aims: This study was designed to compare effect of andexanet alfa (AA) on the thrombin generation potential and its relevance to the generation of thrombin.
Methods: Citrated blood samples from 78 patients with confirmed diagnosis of non-Hodgkin lymphoma (NHL), Hodgkin lymphoma (HL) and Chronic lymphocytic leukemia/Small lymphocytic lymphoma (CLL/SLL) were collected from the Clinic of Hematology Unit, University of Belgrade, Belgrade, Serbia. 50 samples of normal human plasma (NHP) was obtained from George King Biomedical (Overland park, KS). NHP was prepared for referencing purposes. Individual samples were supplemented with andexanet alfa at 100 ug/ml. Thrombin generation studies were carried out using a commercially available a kinetic fluorogenic substrate method (calibrated automated thrombogram; CAT).
Results: On a cumulative basis, lymphoma patients showed an increase in LT (2.9 1.15) in comparison to NHP (2.06 0.2) which decreases with AA (1.94 0.1). The PT levels were decreased (120.34 44.3) in comparison to NHP (159.20 4.8) and increases with AA (153.70 37.2). The AUC was also decreased (668.85 284.3) in comparison to NHP (756.46 34.5) which increases with AA (758.32 226.4). Table 1 shows the data on the sub-group analysis on the effect of andexanet on thrombin generation in lymphoma patients.
Conclusions: The observed decrease in thrombin generation potential in these patients may be due to the consumption of prothrombin and other coagulation factors. Increase in thrombin generation potential in post andexanet samples indicate that andexa promotes thrombogenesis and should be given cautiously in predisposing conditions. Wide variations among these lymphoma groups are noted.
To cite this abstract in AMA style:Siddiqui F, Bontekoe E, Antic D, Hoppensteadt D, Gerotziafas G, Elalamy I, Fareed J. Enhancement of Thrombin Generation in Lymphoma Cohort by Andexanet Alfa [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/enhancement-of-thrombin-generation-in-lymphoma-cohort-by-andexanet-alfa/. Accessed December 10, 2023.
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ISTH Congress Abstracts - https://abstracts.isth.org/abstract/enhancement-of-thrombin-generation-in-lymphoma-cohort-by-andexanet-alfa/