title: Abnormalities of blood coagulation tests in patients with cancer.
abstract: Routine blood coagulation tests were performed on 431 consecutive patients enrolled in a study of the role of anticoagulation in cancer treatment (VA Cooperative Study #75). Two hundred sixteen control patients were treated with standard therapy, and 215 patients were treated with standard therapy plus sodium warfarin. At the time of entry into the study, the most common abnormalities were elevated fibrinogen levels, platelet counts, and fibrinopeptide A levels. Serial studies demonstrated a steady increase in platelet count and fibrinogen levels before death. Anticoagulation lowered FPA levels but had no significant effect on fibrinogen levels, platelet counts, or euglobulin clot lysis times. An unexpected finding was a dramatic increase in fibrin split product levels after institution of anticoagulation (means +/- SEM = 42.6 +/- 116.4 vs. 2.9 +/- 7.0 mg/L in control subjects; P less than 0.02). This study supports the presence of subclinical activation of blood coagulation in most patients with cancer. Moreover, the preferential activation of fibrinolysis in anticoagulated patients suggests a role for a vitamin K-dependent factor(s) in the regulation of fibrinolysis in patients with cancer.
authors: Veterans Administration Medical Center, Newington, Connecticut 06111.
authors: R L
authors: RL
authors: Edwards
authors: F R
authors: FR
authors: Rickles
authors: T E
authors: TE
authors: Moritz
authors: W G
authors: WG
authors: Henderson
authors: L R
authors: LR
authors: Zacharski
authors: W B
authors: WB
authors: Forman
authors: C J
authors: CJ
authors: Cornell
authors: R J
authors: RJ
authors: Forcier
authors: J F
authors: JF
authors: O'Donnell
authors: E
authors: E
authors: Headley
mesh_terms: D001780:Blood Coagulation Tests; D002318:Cardiovascular Diseases / Q000097:blood / Q000188:drug therapy; D005340:Fibrinogen / Q000032:analysis; D005344:Fibrinopeptide A / Q000032:analysis; D006801:Humans; D009369:Neoplasms / Q000097:blood*; D010976:Platelet Count; D013917:Thrombin; D014859:Warfarin / Q000627:therapeutic use
chemical_list: D005344:Fibrinopeptide A; D014859:Warfarin; D005340:Fibrinogen; D013917:Thrombin