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Laboratory assessment of prothrombotic status in patients with primary brain tumors

1Almazov National Medical Research Centre, Saint-Peterburg, Saint Petersburg City, Russia, 2Almazov National Medical Research Centre, Saint Petersburg, Saint Petersburg City, Russia, 3PNPI named by BP Konstantinov of NRC Kurchatov Institute, St. Petersburg, Saint Petersburg City, Russia, 4Almazov National Medical Research Centre, St. Petersburg, Saint Petersburg City, Russia

Abstract Number: VPB0943

Meeting: ISTH 2022 Congress

Theme: Venous Thromboembolism » Cancer Associated Thrombosis

Background: In patients with brain tumors, including gliomas (GM), venous thromboembolism (VTE) is a common complication (20–30%). A rise the platelet – derived circulating extracellular vesicles (EVs) level and activation system coagulation in plasma may contribute to VTE in patients GM.

Aims: To evaluate the use of routine laboratory tests (D-dimer, platelet count) in combination with thrombin generation test and relative abundance platelet-derived EVs in improving VTE risk factor stratification in patients with primary brain tumors.

Methods: In the present study, 11 patients with newly diagnosed GM and 10 healthy volunteers were analyzed. Platelet-derived EVs isolation and identification were performed using Exo-FACS kit (HansaBioMed Life Sciences, Estonia) and monoclonal antibodies CD41-PE/Cy7 as platelet specific markers, determination of the relative abundance by CytoFlex B4-R2-V2 (Beckman Coulter, USA). Thrombin generation test (TGT) were performed by the calibrated automated thrombography method (Thrombinoscope BV, Netherlands).

Results: In patients with GM, the relative abundance of the CD41+ EVs and D-dimer level were significantly higher than in controls (44.3 [40.5; 52.4]% vs 27.2 [22.9; 31]%, p = 0.002; 0.46 [0.38; 1.85] μg/ml FEU vs 0.36 [0.27; 0.40] μg/ml FEU, p = 0.03, respectively). There was a trend towards an increase in peak and rate thrombin formation (p = 0.06) in the GM group. Significant correlation between circulating CD41+ EVs and activation trombin (TGT parameter’s) in the GM group was shown (p < 0.05). During short follow-up period, 3 patients (27%) developed thrombosis, had tumour size more than 5 cm, thrombocytopenia < 150*10^9/L , increased VI (> 95 nmol/min) and D-dimer (> 5 μg/ml FEU).

Conclusion(s): The present pilot study showed that TGT and platelet EVs analysis, in combination with D-dimer and platelet count, can be used to assess the risk of VTE in GM patients. The results of the study need to be confirmed in a larger prospective study.

To cite this abstract in AMA style:

Melniсhnikova O, Zhilenkova J, Zolotova E, Sirotkina O, Pishchulov K, Vavilova T, Moiseeva O, Simakova M. Laboratory assessment of prothrombotic status in patients with primary brain tumors [abstract]. https://abstracts.isth.org/abstract/laboratory-assessment-of-prothrombotic-status-in-patients-with-primary-brain-tumors/. Accessed October 1, 2023.

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