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Tissue factor procoagulant activity of plasma microparticles in patients with cancer-associated disseminated intravascular coagulation

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Abstract

Tissue factor (TF) expressed on sub-cellular membrane vesicles, so-called plasma microparticles (MPs), has recently emerged as a potential key player in intravascular coagulation activation in various disease states. In this report, we demonstrate significantly increased levels of TF-specific procoagulant activity (PCA) of plasma MPs in five patients presenting with overt disseminated intravascular coagulation (DIC) due to an underlying malignancy, including non-small-cell lung cancer (n = 1), melanoma (n = 1), prostate cancer (n = 2), and acute promyelocytic leukemia (n = 1). Clotting experiments on available tumor cell samples suggested that cancer cells were a potential source of circulating TF-positive MPs at least in three of the five patients. Furthermore, follow-up plasma samples from two surviving patients revealed that response of their malignancies to specific anti-cancer therapy was paralleled by resolution of overt DIC and a significant decline in MP-associated TF PCA. Levels of plasma TF antigen, as assessed by an enzyme-linked immunosorbent assay, were also increased at presentation albeit to a lesser extent compared to MP-associated TF PCA, likely due to insufficient solubilization of the phospholipid-incorporated full-length TF molecule by the detergent. In summary, our findings suggest that MP-associated TF PCA may play an important pathogenic role in the evolution of overt DIC in various types of malignancy.

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Authors and Affiliations

  1. Onkologisches Zentrum, II. Medizinische Klinik und Poliklinik, Universitätsklinikum Hamburg-Eppendorf, 20246, Hamburg, Germany

    Florian Langer, Brigitte Spath, Katja Haubold, Katharina Holstein, Jan Wierecky, Tim H. Brümmendorf, Judith Dierlamm, Carsten Bokemeyer & Barbara Eifrig

  2. Institut für Klinische Chemie, Universitätsklinikum Hamburg-Eppendorf, 20246, Hamburg, Germany

    Guy Marx

Authors
  1. Florian Langer
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  2. Brigitte Spath
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  3. Katja Haubold
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  4. Katharina Holstein
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  5. Guy Marx
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  6. Jan Wierecky
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  7. Tim H. Brümmendorf
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  8. Judith Dierlamm
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  9. Carsten Bokemeyer
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  10. Barbara Eifrig
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Correspondence to Florian Langer.

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Langer, F., Spath, B., Haubold, K. et al. Tissue factor procoagulant activity of plasma microparticles in patients with cancer-associated disseminated intravascular coagulation. Ann Hematol 87, 451–457 (2008). https://doi.org/10.1007/s00277-008-0446-3

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  • DOI: https://doi.org/10.1007/s00277-008-0446-3

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