title: Hemostatic effects of high-dose megestrol acetate therapy in patients with advanced gynecological cancer.
abstract: Effects of high-dose megestrol acetate on blood coagulation and fibrinolysis were investigated in patients with gynecological (n = 13) and breast (n = 10) cancer. Patients received either 160 mg or 320 mg/day megestrol acetate orally. Blood sampling was performed prior to and after months 1, 3 and 6 of treatment. Pretreatment values of global clotting times, fibrinogen, factor VII, thrombin-antithrombin III complex, anticoagulation, fibrinolysis and antifibrinolysis were found to be within the reference range. Elevated plasma levels were demonstrated for prothrombin fragments 1 and 2, fibrin degradation products and the plasmin-antiplasmin complex. We demonstrated a significant 20-30% reduction of factor VII until the 3rd month of therapy. No further effects were seen within the remaining 3 months of treatment. For the other analyzed parameters of hemostasis, no significant influence of high-dose progestin treatment was found. Furthermore, we observed no clinically relevant differences between the two dosages. Our results do not provide any evidence that there is a thrombogenic effect of high-dosage megestrol acetate with 160 mg or 320 mg per day amongst patients with advanced gynecological malignancies. The observed incidence of thrombosis might be the consequence of other risk factors such as tumor-induced hypercoagulability, simultaneous chemotherapy or other individual thrombosis risk factors.
authors.affiliation: University Hospital Essen, Center of Gynecology and Obstetrics, Department of Gynecological Oncology, Hufelandstr. 55, D-45122 Essen, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Oberhoff
authors.forename: O
authors.initials: O
authors.lastname: Hoffmann
authors.forename: U H
authors.initials: UH
authors.lastname: Winkler
authors.forename: A E
authors.initials: AE
authors.lastname: Schindler
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001777:Blood Coagulation / Q000187:drug effects*; D001943:Breast Neoplasms / Q000097:blood / Q000188:drug therapy; D016889:Endometrial Neoplasms / Q000097:blood / Q000188:drug therapy; D005260:Female; D005342:Fibrinolysis / Q000187:drug effects*; D005833:Genital Neoplasms, Female / Q000097:blood* / Q000188:drug therapy; D006801:Humans; D019290:Megestrol Acetate / Q000009:adverse effects / Q000494:pharmacology*; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000097:blood / Q000188:drug therapy; D013927:Thrombosis / Q000139:chemically induced
chemical_list: D019290:Megestrol Acetate