Abstract Number: PB1096
Meeting: ISTH 2021 Congress
Background: Gynecological cancers patients are at high risk of venous thromboembolism(VTE) particularly following surgery and during chemotherapy. We have shown that the thrombin generation is increased in these patients and can be used to predict VTE in gynecological cancers (https://doi.org/10.1002/rth2.12342), however the key pathways involved are not understood. Our group has shown that Factor VIIIc(FVIIIc), free Protein S(PS) and Factor V(FV) are significant determinants of thrombin generation in cancer patients (doi: 10.1016/S0049-3848(16)30157-8) and may be useful as predictors of VTE.
Aims: The aim of this study was to compared pre-operative FVIIIc, PS and FV levels in gynecological cancer patients who developed VTE post surgery compared with those who remained thrombosis free. A secondary aim was to determine the effects of FVIIIc, Protein S and Factor V on overall(OS) and progression free survival(PFS).
Methods: 51 gynecological cancer patients who developed VTE during the one year follow-up were matched with 154 gynecological cancer patients who remained thrombosis free. All patients gave full informed written consent and the study was approved by the hospital ethics committee. FVIIIc was measured using a chromogenic substrate assay (Hyphen Biomed), FV (Abcam) PS (Hyphen) were determined by ELISA, 24-48 hours before surgery.
Results: FVIIIc levels were significantly higher in the VTE group(P<0.004) compared to matched controls. There was no significant difference in FV and PS levels between the groups. Factor VIIIc levels above the 75th centile were associated with increased risk of VTE (HR=1.97 (95% CI1.089-3.583)after adjustment for chemotherapy treatment during follow up (HR=1.863 (95% CI1.087-3.38), the association was still significant. There was no association between FV, FVIIIc or PS and OS or PFS.
Conclusions: FVIIIc is increased in gynecological cancer patients prior to the development of VTE. Larger prospective studies are underway in our center to determine the utility of FVIIIc as a predictive tool for VTE in gynecological cancer.
To cite this abstract in AMA style:Ibrahim E, O'Toole S, Ward M, Abu Saadeh F, Norris L. Factor VIIIc Predicts Venous Thromboembolism in Gynecological Cancer Patients [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/factor-viiic-predicts-venous-thromboembolism-in-gynecological-cancer-patients/. Accessed December 5, 2021.
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