title: High coagulation factor VIII and von Willebrand factor in patients with lymphoma and leukemia.
abstract: The risk of venous thromboembolism is increased in patients with lymphoma and leukemia; however, little is known about the potential underlying hereditary or acquired thrombophilia. We prospectively analyzed procoagulant markers and gene mutations in patients with lymphoma (n = 35) and leukemia (n = 10) at diagnosis and over the course of treatment. Global coagulation tests were normal in all patients, as were antithrombin and protein S. Activated protein C resistance caused by the factor V Leiden mutation was found in four patients, one patient had the G20210A mutation of the prothrombin gene, and one patient had protein C deficiency. The most striking findings were sustained very high levels of factor VIII (>150 %) in 30 patients (68 %), which correlated with high von Willebrand factor. An acute phase response in these patients was ruled out by absence of fever and normal IL-6 and -α. Elevated factor VIII is an independent thrombophilic risk factor and may play an etiologic role in thromboembolic complications in patients with malignant lymphoma. Since high von Willebrand factor is most likely caused by endothelial cell injury, an additional, unknown pathophysiological association with malignant lymphoma and acute leukemia is possible.
authors.affiliation: Department of Hematology/Oncology, Magdeburg University Hospital, Magdeburg, Germany. martin.mohren@JKSDL.de.|Klinik für Hämatologie/Onkologie, Johanniter-Krankenhaus Stendal, Wendstr. 31, 39576, Stendal, Germany. martin.mohren@JKSDL.de.
authors.forename: Martin
authors.initials: M
authors.lastname: Mohren
authors.affiliation: Department of Hematology/Oncology, Magdeburg University Hospital, Magdeburg, Germany.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Jentsch-Ullrich
authors.affiliation: Department of Hematology/Oncology, Magdeburg University Hospital, Magdeburg, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Koenigsmann
authors.affiliation: Department of Hematology/Oncology, Magdeburg University Hospital, Magdeburg, Germany.
authors.forename: Siegfried
authors.initials: S
authors.lastname: Kropf
authors.affiliation: Department of Hematology/Oncology, Magdeburg University Hospital, Magdeburg, Germany.
authors.forename: Enrico
authors.initials: E
authors.lastname: Schalk
authors.affiliation: Department of Hematology/Oncology, Magdeburg University Hospital, Magdeburg, Germany.
authors.forename: Gerd
authors.initials: G
authors.lastname: Lutze
mesh_terms: D001780:Blood Coagulation Tests; D005165:Factor V / Q000235:genetics; D005169:Factor VIII / Q000032:analysis*; D005260:Female; D006801:Humans; D007938:Leukemia / Q000097:blood* / Q000150:complications / Q000235:genetics; D008223:Lymphoma / Q000097:blood* / Q000150:complications / Q000235:genetics; D008297:Male; D008875:Middle Aged; D009154:Mutation; D011446:Prospective Studies; D011516:Prothrombin / Q000235:genetics; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000097:blood* / Q000209:etiology*; D014841:von Willebrand Factor / Q000032:analysis*
chemical_list: C095381:factor V Leiden; D014841:von Willebrand Factor; D005165:Factor V; D011516:Prothrombin; D005169:Factor VIII
keywords: Factor VIII; Leukemia; Lymphoma; Thrombophilia; VWF