1. Evaluation of Biomarkers for the Prediction of Venous Thromboembolism in Ambulatory Cancer Patients
- Author
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Schorling, R. M., Pfrepper, C., Golombek, T., Cella, C. A., Munoz-Unceta, N., Siegemund, R., Engel, C., Petros, S., Lordick, F., and Knodler, M.
- Subjects
Male ,Cancer Research ,medicine.medical_specialty ,Biomarkers ,Cholangiocarcinoma ,D-dimer ,Risk assessment models ,Venous thromboembolism ,Antineoplastic Agents ,Risk Assessment ,Fibrin Fibrinogen Degradation Products ,03 medical and health sciences ,Venous thromboembolism, Biomarkers, D-dimer, Risk assessment models, Cholangiocarcinoma ,0302 clinical medicine ,Neoplasms ,Internal medicine ,Ambulatory Care ,medicine ,Humans ,Prospective Studies ,ddc:610 ,cardiovascular diseases ,030212 general & internal medicine ,Mean platelet volume ,Aged ,business.industry ,Thrombin ,Cancer ,Venous Thromboembolism ,Hematology ,Middle Aged ,equipment and supplies ,medicine.disease ,Thrombosis ,P-Selectin ,Oncology ,030220 oncology & carcinogenesis ,Ambulatory ,Biomarker (medicine) ,Female ,business ,Complication ,Risk assessment ,Mean Platelet Volume - Abstract
Background: Venous thromboembolism (VTE) is a common complication of cancer. This study aimed to evaluate immature platelet fraction (IPF), mean platelet volume (MPV), P-selectin, D-dimer, and thrombin generation (TG) as predictive biomarkers for VTE and further the improvement of existing risk assessment models (RAMs). Methods: A prospective, observational, exploratory study was conducted on ambulatory cancer patients with indication for systemic chemotherapy. Baseline RAMs included the Khorana-, Vienna Cancer, Thrombosis-, Protecht-, ONKOTEV-, and Catscore. IPF, MPV, P-selectin, D-dimer, and TG were analysed at baseline and 3-month follow-up. Results: We enrolled 100 patients, of whom 89 completed the follow-up. Frequent tumour types were breast (30%), gastric (14%), gynaecological (14%), and colorectal (14%) cancer. Ten of the 89 patients (11.2%) developed VTE. The highest VTE rate was observed in patients with cholangiocarcinoma (3/5; 60%). Baseline D-dimer levels but not IPF, MPV, or P-selectin were associated with the risk of developing VTE (HR 6.9; p = 0.021). None of the RAMs showed statistical significance in predicting VTE. Peak thrombin and endogenous thrombin potential were lower in patients who developed VTE. Biomarker changes between baseline and follow-up were not associated with VTE risk. Conclusions: VTE risk was well predicted by baseline D-dimer levels. Adding D-dimer could improve existing RAMs to better identify patients who may benefit from primary VTE prophylaxis. The VTE risk among patients with cholangiocarcinoma should be further evaluated.
- Published
- 2020
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