Abstract
It is well known that solid cancers are associated with thromboembolic complications, but recent studies have shown that the incidence of thrombosis may be as high (or even higher) in patients with malignant haematological disorders. However, this may be obscured by the significant morbidity and mortality due to other complications of haematological malignancies, such as bleeding and infections. The vast majority of patients with haematological neoplasias also have clinically silent haemostatic abnormalities, but some may show clinical manifestations, including venous thromboembolism, pulmonary embolism, disseminated intravascular coagulation and life-threatening thrombohaemorrhagic syndrome in acute leukaemias. The pathogenesis of thromboembolic disease in haematological malignancies is complex and multifactorial: tumour cell-derived procoagulant, fibrinolytic or proteolytic factors and inflammatory cytokines affect clotting activation, and chemotherapy and anti-angiogenic drugs increase thrombotic risk in patients with lymphoma, acute leukaemia and multiple myeloma. Infectious complications are another important factor: endotoxins from gramnegative bacteria induce the release of tissue factor (TF), tumour necrosis factor (TNF) and interleukin-1b (IL-1b), and gram-positive organisms can release bacterial mucopolysaccharides that directly activate factor XII. Leukaemic patients may be affected by other prothrombotic factors, including hyperleukocytosis, increased TF expression and activation, and the prothrombotic properties of therapeutic agents such as all-trans retinoic acid and L-asparaginase, which can induce thrombosis involving multiple organs. The very high risk of haemorrhage in these patients warrants prospective randomised trials evaluating optimal anti-thrombotic prophylaxis and treatment.
Keywords: Venous thromboembolism, haematologic malignancies, cancer, bleeding
Current Vascular Pharmacology
Title: Thromboembolic Complications in Malignant Haematological Disorders
Volume: 8 Issue: 4
Author(s): Roberto Castelli, Barbara Ferrari, Agostino Cortelezzi and Achille Guariglia
Affiliation:
Keywords: Venous thromboembolism, haematologic malignancies, cancer, bleeding
Abstract: It is well known that solid cancers are associated with thromboembolic complications, but recent studies have shown that the incidence of thrombosis may be as high (or even higher) in patients with malignant haematological disorders. However, this may be obscured by the significant morbidity and mortality due to other complications of haematological malignancies, such as bleeding and infections. The vast majority of patients with haematological neoplasias also have clinically silent haemostatic abnormalities, but some may show clinical manifestations, including venous thromboembolism, pulmonary embolism, disseminated intravascular coagulation and life-threatening thrombohaemorrhagic syndrome in acute leukaemias. The pathogenesis of thromboembolic disease in haematological malignancies is complex and multifactorial: tumour cell-derived procoagulant, fibrinolytic or proteolytic factors and inflammatory cytokines affect clotting activation, and chemotherapy and anti-angiogenic drugs increase thrombotic risk in patients with lymphoma, acute leukaemia and multiple myeloma. Infectious complications are another important factor: endotoxins from gramnegative bacteria induce the release of tissue factor (TF), tumour necrosis factor (TNF) and interleukin-1b (IL-1b), and gram-positive organisms can release bacterial mucopolysaccharides that directly activate factor XII. Leukaemic patients may be affected by other prothrombotic factors, including hyperleukocytosis, increased TF expression and activation, and the prothrombotic properties of therapeutic agents such as all-trans retinoic acid and L-asparaginase, which can induce thrombosis involving multiple organs. The very high risk of haemorrhage in these patients warrants prospective randomised trials evaluating optimal anti-thrombotic prophylaxis and treatment.
Export Options
About this article
Cite this article as:
Castelli Roberto, Ferrari Barbara, Cortelezzi Agostino and Guariglia Achille, Thromboembolic Complications in Malignant Haematological Disorders, Current Vascular Pharmacology 2010; 8 (4) . https://dx.doi.org/10.2174/157016110791330799
DOI https://dx.doi.org/10.2174/157016110791330799 |
Print ISSN 1570-1611 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6212 |
Call for Papers in Thematic Issues
Advancements in Arterial Stiffness: Novel Therapeutic Frontiers
Arterial stiffness, a hallmark of cardiovascular disease, poses significant challenges in contemporary healthcare. This thematic issue delves into the multifaceted landscape of arterial stiffness and explores cutting-edge therapeutic interventions aimed at mitigating its adverse effects. Within these pages, readers will find a comprehensive overview of the mechanisms underlying arterial stiffness, ...read more
TREATMENT OF CARDIOVASCULAR DISEASE IN CHRONIC AND END STAGE KIDNEY DISEASE
Cardiovascular disease still remains the leading cause of death in Chronic and End Stage Kidney Disease, accounting for more than half of all deaths in dialysis patients. During the past decade, research has been focused on novel therapeutic agents that might delay or even reverse cardiovascular disease and vascular calcification, ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Microtubule Targeting Agents: A Benchmark in Cancer Therapy
Current Drug Therapy New, Substituted Derivatives of Dicarboximides and their Cytotoxic Properties
Anti-Cancer Agents in Medicinal Chemistry Stem Cell Transplantation and MBL Replacement Therapy
Current Stem Cell Research & Therapy New Directions in Targeting Protein Kinases: Focusing Upon True Allosteric and Bivalent Inhibitors
Current Pharmaceutical Design Forodesine (BCX-1777, Immucillin H) - A New Purine Nucleoside Analogue: Mechanism of Action and Potential Clinical Application
Mini-Reviews in Medicinal Chemistry Exploitation of Apoptosis Pathways for Childhood Leukemia
Current Pediatric Reviews Synthesis and Evaluation of New Thiazolyl Hydrazone Derivatives as Potential Anticancer Agents
Letters in Drug Design & Discovery A Novel Role of the STAT3 Pathway in Brain Inflammation-induced Human Neural Progenitor Cell Differentiation
Current Molecular Medicine Equilibrative Nucleoside Transporters in Fetal Endothelial Dysfunction in Diabetes Mellitus and Hyperglycaemia
Current Vascular Pharmacology Immunotherapy for Alzheimers Disease: Rational Basis in Ongoing Clinical Trials
Current Pharmaceutical Design Strategies to Improve the Killing of Tumors Using Temozolomide: Targeting the DNA Repair Protein MGMT
Current Medicinal Chemistry Editorial (Hot Topic:Recent Advance in the Studies of Beta-glucans for Cancer Therapy)
Anti-Cancer Agents in Medicinal Chemistry Src Kinase Inhibitors: An Update on Patented Compounds
Current Medicinal Chemistry Interplay between Epigenetics & Cancer Metabolism
Current Pharmaceutical Design Inhibitors of the PI3K/Akt/mTOR Pathway: New Hope for Breast Cancer Patients
Recent Patents on Anti-Cancer Drug Discovery Network-Based Strategies Can Help Mono- and Poly-pharmacology Drug Discovery: A Systems Biology View
Current Pharmaceutical Design Unleashing the Guardian: The Targetable BCR-ABL/HAUSP/PML/PTEN Network in Chronic Myeloid Leukemia
Current Drug Targets Gene Therapy for the Peripheral Nervous System: A Strategy to Repair the Injured Nerve?
Current Gene Therapy Cells Under Pressure – Treatment of Eukaryotic Cells with High Hydrostatic Pressure, from Physiologic Aspects to Pressure Induced Cell Death
Current Medicinal Chemistry Microscopies at the Nanoscale for Nano-Scale Drug Delivery Systems
Current Drug Targets