PO-57 - Problems of diagnostics of rare localizations thrombosis in cancer patients

A Vorobev; A Makatsaria

doi:10.1016/S0049-3848(16)30190-6

PO-57 - Problems of diagnostics of rare localizations thrombosis in cancer patients

Thromb Res. 2016 Apr:140 Suppl 1:S197. doi: 10.1016/S0049-3848(16)30190-6. Epub 2016 Apr 8.

Authors

A Vorobev¹, A Makatsaria¹

Affiliation

¹ Faculty of Obstetrics and Gynecology, The First Moscow State Medical Sechenov University, Moscow, Russia.

PMID: 27161745
DOI: 10.1016/S0049-3848(16)30190-6

Abstract

Introduction: Thrombosis of rare localizations: hepatic vein thrombosis, splenic, mesenteric, ovarian veins, brain, portal vein are life-threatening disorders, which often goes unrecognized. The most frequently atypical localizations develop thrombosis in patients with inherited defects of hemostasis - genetic thrombophilia. Rare localizations of thrombosis often accompanied acquired abnormalities of hemostasis, which include antiphospholipid syndrome, hypercoagulation in oncology.

Aim: The detection of thrombosis rare localizations required screening for genetic forms of thrombophilia and antiphospholipid syndrome and timely appointment of anticoagulant therapy.

Materials and methods: Since 2006 we have observed 1214 patients with gynecological cancer.

Results: In 10 cases we have observed unusual localization thrombosis: Hepatic vein thrombosis (Budd-Chiari syndrome) - in 1 case, Splenic vein thrombosis - 2 cases, renal vein thrombosis - 1 case, thrombosis of retinal artery and vein - 3 cases, Cerebral venous thrombosis - 1 case, mesenteric thrombosis - 2 cases, one of them has lead to death in early postsurgery period. APA circulation has been found in all cases: antibodies to B2Gp1a, antibodies to Annexin V and antibodies to prothrombin. The factor FV Leiden homozygous mutation was found 9 patients, except 1 patient with retinal vein thrombosis, the homozygous MTHFR mutation has been found in 9 patients, heterozygous in 2; prothrombin mutation in 9; PAI-1 polymorphism in all 10 cases, platelets glycoproteins polymorphism in 7 cases. In 56 y.o. patient with ovarian cancer despite of anticoagulation therapy with LMWH has been found mesenteric thrombosis in 2 day after surgery. In addition to the above mentioned mutations it was found ADAMTS13 gene mutation.

Conclusions: Presence of multigene forms of genetic thrombophilia and APA-circulation increase risk of rare localizations thrombotic complications in cancer patients, therefore such patients required in intensive permanent preventive maintenance with use of LMWH.