Antiphospholipid antibodies associated with malignancies: clinical and pathological characteristics of 120 patients.
OBJECTIVE
To describe the different types of malignancies associated with antiphospholipid antibodies (aPL).


METHODS
We performed a computer-assisted (MEDLINE, National Library of Medicine, Bethesda, MD) search of the literature from 1966 to 2003 to identify all cases of malignancies having aPL.


RESULTS
One hundred twenty patients were found. The mean age was 56+/-17 years (range 5 to 88). Sixty-two (52%) patients were men and 58 (48%) were women. A heterogeneous group of malignancies were found. Regarding hematological malignancies, 10 (8%) patients suffered from B-cell lymphoma, 8 (7%) from spleen lymphoma, 7 (6%) from chronic myeloid leukemia, and 6 (5%) from non-Hodgkin's lymphoma (NHL). Regarding solid tumors, renal cell carcinoma was diagnosed in 7 (6%) patients, primary tumor with unknown origin in 7 (6%), lung adenocarcinoma in 6 (5%), breast carcinoma in 6 (5%), and melanoma in 6 (5%). The main aPL-related manifestations were thrombocytopenia (25%), cerebrovascular accidents (24%), deep vein thrombosis (19%), pulmonary embolism (15%), and heart valve lesions (9%). In 17 cases, catastrophic antiphospholipid syndrome was considered to be triggered by the malignancy. Seventy-one (63%) of 113 patients recovered or are still alive after cancer treatment. Twenty-three (35%) of 65 patients achieved aPL remission after proper treatment of the malignancy.


CONCLUSIONS
It is important to bear in mind, especially in elderly patients, that thrombotic events associated with aPL can be the first manifestation of malignancy. At the same time, the presence of aPL in patients with malignancies has important implications in their treatment and prognosis.
Gómez-Puerta
José A
JA
Department of Autoimmune Diseases, Institut Clínic de Medicina i Dermatologia (ICMiD), Hospital Clínic, Barcelona, Catalonia, Spain.
Cervera
Ricard
R
Espinosa
Gerard
G
Aguiló
Sira
S
Bucciarelli
Silvia
S
Ramos-Casals
Manuel
M
Ingelmo
Miguel
M
Asherson
Ronald A
RA
Font
Josep
J
D017152:Antibodies, Antiphospholipid / Q000276:immunology*; D006801:Humans; D009369:Neoplasms / Q000276:immunology* / Q000473:pathology* / Q000628:therapy; D011379:Prognosis
D017152:Antibodies, Antiphospholipid