Abstract 2690: Evaluation of the hemostatic status in patients with prostate cancer using thromboelastography and tissue factor- microparticles

Coagulopathy is reported as the second most common cause of death from cancers, particularly prostate cancer. DVT and pulmonary embolism are two major thrombotic complications in prostate cancer and the risk is even higher with chemotherapy and hormonal therapy. Thromboelastography (TEG) is a global hemeostatic test that detects and specifies the type of coagulopathy encountered through a vesicoelastic trace that reflects the kinetics of the clot from the initial fibrin thread till and fibrinolysis. We performed a hemostatic study in 27 patients (age range 59-88 years) diagnosed with prostate cancer at various stages (metastatic and non-metastatic) as compared to a control group (n=9) matching the same age range and with -ve pathology for prostate cancer. The study included whole blood TEG and flow cytometry analysis of microprticles (MPs) in plasma using Annexin V- FITC and anti-tissue factor - PE. Analysis of the data revealed hypercoagulable state in all patients except two who were maintained on coumadin as prophylaxis for previous DVT. Hypercoagulability was indicated by shorter R time, increased alpha angle, MA and clot index. The mean values for TEG parameters in the patients were: R: 6.01 vs 9.8 minutes in the control group, alpha angle: 68.3 vs 53.1 degrees in controls, MA: 69.3 vs 57.9 mm in controls, and CI: 3.32 vs 0.7 in controls. Paired student t test showed significant differences as regards R time (P=0.009), MA (p=0.053) and CI (P=0.051). Microparticle assay revealed significant elevation in the number of microparticles carrying tissue factor in the patient group compared to the control group (p=0.05). The mean plasma TF-MPs in patient group was 5,142 MPs/uL compared to 2,914 MPs/ uL in the control group suggesting a link between elevated tissue factor and hypercoagulability observed in these patients. To our knowledge, this is the first report for the use of TEG in patients with prostate cancer. TEG is a relatively simple test that uses a small volume of blood and can be a useful tool for evaluation of patients’ thrombotic potential and may help identification of those who may require anticoagulant prophylaxis. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 2690. doi:1538-7445.AM2012-2690