Congenital and acquired thrombotic risk factors in lymphoma patients bearing upper extremities deep venous thrombosis: a preliminary report

Di, Niglio Alferio, De, Lucania Anna, Scudiero Olga, Castaldo, Castaldo Giuseppe

Description

Congenital thrombotic risk factors, oncological diseases and its therapies have been related to an increased occurrence of upper extremities deep venous thrombosis (UEDVT). Patients and methods We studied seven patients bearing lymphoma (one Hodgkin's and six non-Hodgkin's) who developed UEDVT, one at diagnosis and six during chemotherapy (two of these six cases had implantation of a central venous catheter and four received Growth Colony Stimulating Factors in addition to chemotherapy). Patients were screened for: factor V G1691A (Leiden), prothrombin G20210A, methylene tetrahydrofolate reductase (MTHFR) C677T mutations and antithrombin III, proteins C and S plasma activity. Results All patients were wild-type homozygotes for G20210A. One was heterozygote for factor V G1691A, the other 6 were wild-type homozygotes. Three of the 7 patients were homozygotes and 2 heterozygotes for the MTHFR mutation; the remaining 2 were wild-type homozygotes. Clotting inhibitor levels were normal in all patients. Conclusions UEDVT in patients bearing haematological malignancies can occur irrespective of congenital thrombophilic alterations. However, in a subgroup of patients UEDVT could also depend on congenital thrombophilic alterations. A screening for inherited thrombophilia can identify high risk patients that could be specifically treated to prevent thrombotic complications.

Sujets

• Malignancy
• Non-Hodgkin lymphoma
• Hodgkin's lymphoma
• Central venous catheter
• Granulocyte colony-stimulating factor

Informations

• Publié par: biomed
• Publié le: 01 janvier 2004
• Nombre de lectures: 11
• Langue: English

Extrait

Journal of Translational Medicine

BioMedCentral

Open Access Research Congenital and acquired thrombotic risk factors in lymphoma patients bearing upper extremities deep venous thrombosis: a preliminary report 1 12 2 Pierpaolo Di Micco*, Alferio Niglio, Amalia De Renzo, Anna Lucania, 3 33,4 Rosanna Di Fiore, Olga Scudieroand Giuseppe Castaldo

1 2 Address: Divisionedi Medicina Interna, Seconda Università di Napoli, Naples, Italy,Divisione di Ematologia, Università di Napoli "Federico II", 3 Naples, Italy,Dipartimento di Biochimica e Biotecnologie Mediche e CEINGEBioteconologie avanzate, Università di Napoli "Federico II", 4 Naples, Italy andFacoltà di Scienze, Università del Molise, Aesernia, Italy

Email: Pierpaolo Di Micco*  [e-mail]; Alferio Niglio  [e-mail]; Amalia De Renzo  [e-mail]; Anna Lucania  [e-mail]; Rosanna Di Fiore  [e-mail]; Olga Scudiero  [e-mail]; Giuseppe Castaldo  [e-mail] * Corresponding author

Published: 22 March 2004Received: 03 January 2004 Accepted: 22 March 2004 Journal of Translational Medicine2004,2:7 This article is available from: http://www.translational-medicine.com/content/2/1/7 © 2004 Di Micco et al; licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL.

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Abstract Background:Congenital thrombotic risk factors, oncological diseases and its therapies have been related to an increased occurrence of upper extremities deep venous thrombosis (UEDVT). Patients and methods:We studied seven patients bearing lymphoma (one Hodgkin's and six non-Hodgkin's) who developed UEDVT, one at diagnosis and six during chemotherapy (two of these six cases had implantation of a central venous catheter and four received Growth Colony Stimulating Factors in addition to chemotherapy). Patients were screened for: factor V G1691A (Leiden), prothrombin G20210A, methylene tetrahydrofolate reductase (MTHFR) C677T mutations and antithrombin III, proteins C and S plasma activity. Results:All patients were wild-type homozygotes for G20210A. One was heterozygote for factor V G1691A, the other 6 were wild-type homozygotes. Three of the 7 patients were homozygotes and 2 heterozygotes for the MTHFR mutation; the remaining 2 were wild-type homozygotes. Clotting inhibitor levels were normal in all patients. Conclusions:UEDVT in patients bearing haematological malignancies can occur irrespective of congenital thrombophilic alterations. However, in a subgroup of patients UEDVT could also depend on congenital thrombophilic alterations. A screening for inherited thrombophilia can identify high risk patients that could be specifically treated to prevent thrombotic complications.

Introduction Upper extremities deep venous thrombosis (UEDVT) is much less frequent than lower extremities deep venous

thrombosis (LEDVT) [1,2]. However, UEDVT is frequent in patients affected by malignancies and bearing central venous catheters [3]. Given the association between

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