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Thrombophilia identified as a risk factor for thrombogenesis in cancer patients

https://doi.org/10.17749/2313-7347/ob.gyn.rep.2021.232

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Abstract

Aim: to assess a rate and range of genetic and acquired thrombophilia in onco-gynecologic patients with ovarian cancer, uterine corpus cancer and cervical cancer.

Materials and Мethods. A prospective controlled cohort non-randomized interventional study was conducted: within the years 2014 to 2020, there were examined 546 women with genital malignancies, divided into 2 groups: group I – 155 cancer patients with former thrombosis, group II – 391 women with female genital cancer without former thrombotic complications. Control group consisted of 137 patients with benign female genital tumors. The spectrum of circulating APA was studied: antibodies to â2-glycoprotein I (â2-GPI), annexin V and prothrombin as well as genetic thrombophilia due to mutations genes encoding factor V Leiden, methylenetetrahydrofolate reductase (MTHFR) including polymorphism in genes for prothrombin, platelet glycoproteins and plasminogen activator inhibitor-1 (PAI-1).

Results. It was found that frequency of circulating APA as well as incidence rate of genetic thrombophilia between cancer patients from group I vs. group II significantly differed: APA in group I vs. group II was 86 (55.5 %; p < 0.01) vs. 92 (23.5 %) compared to 7 (5.1 %) in control group. Genetic thrombophilia was dominated in group I by mutated MTHFR (92.9 %), polymorphismin PAI-1 (28.4 %) and platelet glycoprotein (44.5 %) that were significantly higher (p < 0.05) compared to group II and control group. Hence, it allows to suggest that such identified thrombophilia markers are largely associated with a risk of developing thrombotic complications.

Conclusion. Detected high percentage of patients with circulating APA and genetic thrombophilia among cancer patients with former thromboembolic complications corroborate a role for genetic and acquired thrombophilia in developing pre-thrombotic condition. Detecting a range of circulating APA and genetic thrombophilia allows to identify patients who might be referred to a high risk of thrombogenesis and require to preventive application of anticoagulant therapy.

About the Authors

A. V. Vorobev
Sechenov University
Russian Federation

Alexander V. Vorobev – MD, PhD, Associate Professor, Department of Obstetrics and Gynecology, Filatov Clinical Institute of Children’s Health

Scopus Author ID: 57191966265; Researcher ID: F-8804-2017

2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991



A. D. Makatsariya
Sechenov University
Russian Federation

Alexander D. Makatsariya – MD, Dr Sci Med, Professor, Academician of RAS, Head of the Department of Obstetrics and Gynecology, Filatov Clinical Institute of Children’s Health

Scopus Author ID: 57222220144; Researcher ID: M-5660-2016

2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991



V. O. Bitsadze
Sechenov University
Russian Federation

Viktoriya O. Bitsadze – MD, Dr Sci Med, Professor of RAS, Professor, Department of Obstetrics and Gynecology, Filatov Clinical Institute of Children’s Health

Scopus Author ID: 6506003478; Researcher ID: F-8409-2017

2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991



A. G. Solopova
Sechenov University
Russian Federation

Antonina G. Solopova – MD, Dr Sci Med, Professor, Department of Obstetrics and Gynecology, Filatov Clinical Institute of Children's Health

Scopus Author ID: 6505479504. Researcher ID: Q-1385-2015

2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991



D. A. Ponomarev
Maternity Hospital № 4 – Branch of Vinogradov City Clinical Hospital, Moscow Healthcare Department
Russian Federation

Dmitry A. Ponomarev – MD, Obstetrician-Gynecologist of the Highest Category, Head

3 Novatorov Str., Moscow 119421



References

1. Khorana A.A., Francis C.W., Culakova E. et al. Thromboembolism is a leading cause of death in cancer patients receiving outpatient chemotherapy. J Thromb Haemost. 2007;5(3):632–4. https://doi.org/10.1111/j.1538-7836.2007.02374.x.

2. Horsted F., West J., Grainge M.J. Risk of venous thromboembolism in patients with cancer: a systematic review and meta-analysis. PLoS Med. 2012;9(7):e1001275. https://doi.org/10.1371/journal.pmed.1001275.

3. Kim A.S., Khorana A.A., McCrae K.R. Mechanisms and biomarkers of cancer-associated thrombosis. Transl Res. 2020;225:33–53. https://doi.org/10.1016/j.trsl.2020.06.012.

4. Blom J.W., Doggen C.J.M., Osanto S., Rosendaal F.R. Malignancies, prothrombotic mutations, and the risk of venous thrombosis. JAMA. 2005;293(6):715–22. https://doi.org/10.1001/jama.293.6.715.

5. Khorana A.A., Dalal M., Lin J., Connolly G.C. Incidence and predictors of venous thromboembolism (VTE) among ambulatory high-risk cancer patients undergoing chemotherapy in the United States. Cancer. 2013;119(3):648–55. https://doi.org/10.1002/cncr.27772.

6. Noble S., Pasi J. Epidemiology and pathophysiology of cancer-associated thrombosis. Br J Cancer. 2010;102 Suppl 1(Suppl 1):S2–9. https://doi.org/10.1038/sj.bjc.6605599.

7. Khorana A.A., Kuderer N.M., Culakova E. et al. Development and validation of a predictive model for chemotherapy-associated thrombosis. Blood. 2015;111(10):4902–8. https://doi.org/10.1182/blood-2007-10-116327.

8. Ay C., Dunkler D., Marosi C. et al. Prediction of venous thromboembolism in cancer patients. Blood. 2010;116(24):5377–82. https://doi.org/10.1182/blood-2010-02-270116.

9. Pabinger I., van Es N., Heinze G. et al. A clinical prediction model for cancer-associated venous thromboembolism: a development and validation studyin two independent prospective cohorts. Lancet Haematol. 2018;5(7):e289–e298. https://doi.org/10.1016/S2352-3026(18)30063-2.

10. Martín A.J.M, Ortega I., Font C. et al. Multivariable clinical-genetic risk model for predicting venous thromboembolic events in patients with cancer. Br J Cancer. 2018;118(8):1056–61. https://doi.org/10.1038/s41416-018-0027-8.

11. Murthy S.B., Cushman M., Bobrow D. et al. Ability of the Khorana score to predict recurrent thromboembolism in cancer patients with ischemic stroke. J Clin Neurosci. 2018;57:111–5. https://doi.org/10.1016/j.jocn.2018.08.018.

12. Pabinger I., Ay C., Dunkler D. et al. Factor V Leiden mutation increases the risk for venous thromboembolism in cancer patients – results from the Vienna Cancer And Thrombosis Study (CATS). J Thromb Haemost. 2015;13(1):17–22. https://doi.org/10.1111/jth.12778.

13. Soria J.M., Morange P.-E., Vila J. et al. Multilocus genetic risk scores for venous thromboembolism risk assessment. J Am Heart Assoc. 2014;3(5):e001060. https://doi.org/10.1161/JAHA.114.001060.

14. Gran O.V., Smith E.N., Brækkan S.K. et al. Joint effects of cancer and variants in the factor 5 gene on the risk of venous thromboembolism. Haematologica. 2016;101(9):1046–53. https://doi.org/10.3324/haematol.2016.147405.

15. Kennedy M., Andreescu A.C.M., Greenblatt М. S. et al. Factor V Leiden, prothrombin 20210A and the risk of venous thrombosis among cancer patients. Br J Haematol. 2005;128(3):386–8. https://doi.org/10.1111/j.1365-2141.2004.05327.x.

16. Heraudeau A., Delluc A., Le Henaff M. et al. Risk of venous thromboembolism in association with factor V leiden in cancer patients – The EDITH case-control study. PLoS One. 2018;13(5):e0194973. https://doi.org/10.1371/journal.pone.0194973.


Review

For citations:


Vorobev A.V., Makatsariya A.D., Bitsadze V.O., Solopova A.G., Ponomarev D.A. Thrombophilia identified as a risk factor for thrombogenesis in cancer patients. Obstetrics, Gynecology and Reproduction. 2021;15(3):228-235. (In Russ.) https://doi.org/10.17749/2313-7347/ob.gyn.rep.2021.232

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ISSN 2313-7347 (Print)
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