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Semin Thromb Hemost 2024; 50(03): 402-412
DOI: 10.1055/s-0043-1770364
Review Article

Fibrin Clot Properties in Cancer: Impact on Cancer-Associated Thrombosis

Michał Ząbczyk
1   Thromboembolic Disorders Department, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland
2   Krakow Center for Medical Research and Technologies, John Paul II Hospital, Krakow, Poland
,
Anetta Undas
1   Thromboembolic Disorders Department, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland
2   Krakow Center for Medical Research and Technologies, John Paul II Hospital, Krakow, Poland
› Institutsangaben
Funding This study was supported by the Jagiellonian University Medical College (Grant Number N41/DBS/000682, to A.U.).
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Abstract

Cancer is associated with a high risk of venous thromboembolism (VTE) and its recurrence. There is evidence that the prothrombotic fibrin clot phenotype, involving the formation of denser and stiffer clots relatively resistant to lysis, occurs in cancer patients, which is in part related to enhanced inflammation, oxidative stress, and coagulation activation, along with the release of neutrophil extracellular traps, indicating that fibrin-related mechanisms might contribute to cancer-associated thrombosis (CAT). Multiple myeloma and its therapy have been most widely explored in terms of altered fibrin characteristics, but prothrombotic fibrin clot features have also been reported in patients with active solid cancer, including lung cancer and gastrointestinal cancer. Patient-related factors such as advanced age, smoking, and comorbidities might also affect fibrin clot characteristics and the risk of CAT. Prothrombotic fibrin clot features have been shown to predict the detection of cancer in patients following VTE during follow-up. Cancer-specific therapies and anticoagulation can favorably modify the phenotype of a fibrin clot, which may alter the course of CAT. It is unclear whether the fibrin clot phenotype might help identify patients with CAT who are more likely to experience recurrent events. This narrative review summarizes the current knowledge on the role of fibrin clot structure and function in cancer patients in the context of CAT.

Keywords

cancer - cancer-associated thrombosis - fibrin clot - fibrinolysis - venous thromboembolism

Author Contribution

M.Z. reviewed literature and drafted the manuscript and A.U. revised and edited the manuscript.


Data Availability

No new data were generated or analyzed in support of this research.




Publikationsverlauf

Artikel online veröffentlicht:
23. Juni 2023

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