PMID: 9433535Jan 20, 1998Paper

Hemostatic abnormalities associated with cancer and its therapy

Annals of Clinical and Laboratory Science
A B Glassman

Abstract

Hemostatic abnormalities associated with malignancy have been described since the middle of the 19th century. Abnormalities associated with hypercoagulability and hemorrhage are reported in various percentages of patients depending upon the underlying neoplasm and the type of therapy. Changes in the quantitative and qualitative aspects of protein coagulation factors, anticoagulant proteins, circulating anticoagulants, platelets, and vascular responses have been noted. Clinical or subclinical disseminated intravascular coagulopathy (DIC) and associated paradoxical bleeding are common. Hemorrhage may be associated with a decrease of particular coagulation factors or alterations of vascular integrity and platelet numbers or function in various combinations. Evaluation of hemostatic abnormalities associated with cancer (HAAC) includes a careful history and physical examination, assessment of the prothrombin and activated partial thromboplastin times, platelet count, a test for fibrin or fibrinogen degradation products, and assay of fibrinogen levels. Specific findings may suggest the need for tests for naturally occurring protein anticoagulants (e.g., protein S, protein C, and antithrombin III), coagulation inhibitors, abnormalitie...Continue Reading

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