Evidence of haemostatic activation has been demonstrated in cancer patients.The role of chemotherapy as a risk factor for venous thrombosis has been reported during therapy for breast cancer (tamoxifen) and for Multiple Myeloma (thalidomide).Among the markers of thrombin activation, D-dimer test has been found increased after chemotherapy for breast and lung cancer (Weitz et al., Thromb Haemost 2002; 88: 213(220).However, the type of cancer and the regimen of chemotherapy give a different risk of thrombosis.Therefore, no definitive conclusions are present on the role of markers of thrombin activation for identifying patients, on chemotherapy, at high risk of thrombosis.In an ongoing clinical trial, we assessed D-dimer levels in patients on chemotherapy for cancer of the colon.Materials and methods: Consecutive patients receiving adjunctive chemotherapy for colon neoplasm were considered eligible.D-dimer test was tested at the beginning and at the end of any cycle of chemotherapy.Standard chemotherapy consists in Campto (CPT11) 180 mg/mq, and Fluororacile (400 and 600 mg/mq) for 2 days.D-dimer was furnished by Dade Behring (D-dimer PLUS, turbidimetric methods, normal value <192 m L).D-dimer variation before and after chemotherapy was assessed by Wilcoxon test.Objective test for deep vein thrombosis (DVT) and/or pulmonary embolism (PE) were performed in symptomatic patients during the follow-up.Results: At the interim analysis, 26 patients were evaluated; D-dimer levels did not vary between the beginning and the end of chemotherapy (1 st cycle P = 0.8, 2 nd cycle P = 0.9, 3 rd cycle 0.67, 4 th cycle 0.79).One patient only (3.4%) developed symptomatic DVT of the upper limb; he had a central venous line.The last determination of D-dimer level was 1298 m L. Conclusion: At the present, our study does not confirm a significant increase of D-dimer levels in patients on chemotherapy for cancer of the colon.
原文链接
分享
引用
