Prevalence and Impact of Antiphospholipid Antibodies on Thrombotic Events in Ambulatory Cancer Patients

C. Kansuttiviwat¹, P. Niprapan², L. Norasetthada², E. Rattaritamrong², A. Tantiworawit², P. Piriyakhuntorn², S. Hantrakool³, N. Hantrakun², T. Punnachet², C. Chai-Adisaksopha²

¹Faculty of Medicine, Chiang Mai University, Thailand, Chiang Mai, Thailand, ²Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand, Sri Phum, Muang, Chiang Mai, Thailand, ³Division of Hematology, Department of Internal Medicine, Chiang Mai University, Sri Phum, Muang, Chiang Mai, Thailand

Abstract Number: VPB0737

Meeting: ISTH 2022 Congress

Theme: Hemostatic Systems in Cancer, Inflammation and Immunity » Coagulation Proteins Beyond Hemostasis

Background: Despite the conflicting data, the positivity of antiphospholipid antibodies (APLA) in cancer patients may be associated with an increased risk of thrombosis.

Aims: To identify the prevalence of APLA and impact of APLA on arterial and venous thrombosis in ambulatory cancer patients

Methods: This was a prospective cohort study. We enrolled newly diagnosed ambulatory cancer patients receiving chemotherapy. Controls were enrolled from age- and sex-matched non-cancer, non-autoimmune disease population. Participants were evaluated for APLA (lupus anticoagulant (LA), anti-cardiolipin (aCL) and anti-β2 glycoprotein 1 (anti-β2-GPI). Primary outcome was the prevalence of APLA positivity. Secondary outcomes were the prevalence of arterial and venous thrombosis and all-cause mortality at 6-month follow-up duration.

Results: There were 137 cases and 137 controls with mean age of 56.0±12.3 and 55.5±12.1 years, respectively. Cancer patients were more likely to have APLA positivity compared to controls, with risk difference of 2.9% (95% CI 0.1 to 5.7) for dual LA positivity, 5.8% (95% CI 0.2 to 9.7) for aCL IgM or IgG and 6.6% (-0.7 to 13.1) for anti-β2-GPI IgM or IgG (Table 1). Composites of venous and arterial thrombosis occurred in 10 (7.3%) in cancer patients and 2 (4.5%) in controls. Death occurred in 19 (13.9%) in cancer patients and 0% in controls. In cancer patients who had any APLA positivity were associated with higher risk of composites of venous and arterial thrombosis compared to those without (RR 3.6, 95% CI 1.0-12.4). Cancer patients with LA positivity were associated with higher risk of arterial or venous thrombosis (RR 5.3 95%CI 1.3-21.0), whereas patients with anti-β2-GPI positivity were associated with higher risk of venous thrombosis (RR 4.7, 95%CI 1.1-19.2), Table 2.

Conclusion(s): APLA was more prevalent in patients with active cancer than non-cancer patients. Positive APLA in cancer patients was associated with arterial or venous thrombosis.

Table 1.

Antiphospholipid antibodies profiles in cancer patients and controls

Table 2

Impact of APLA on Venous thrombosis, arterial thrombosis in cancer patients according to types of APLA

To cite this abstract in AMA style:

Kansuttiviwat C, Niprapan P, Norasetthada L, Rattaritamrong E, Tantiworawit A, Piriyakhuntorn P, Hantrakool S, Hantrakun N, Punnachet T, Chai-Adisaksopha C. Prevalence and Impact of Antiphospholipid Antibodies on Thrombotic Events in Ambulatory Cancer Patients [abstract]. https://abstracts.isth.org/abstract/prevalence-and-impact-of-antiphospholipid-antibodies-on-thrombotic-events-in-ambulatory-cancer-patients/. Accessed September 27, 2023.

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