ABSTRACT
Rheological alterations are commonly found in malignant disease and are most pronounced
in advanced-stage cancer. Although most of these changes are caused by cancer-unspecific
mechanisms, it has been shown that the extent of these changes in some cancer types
is related with the stage of cancer, prognosis of disease, and the patient's risk
for thrombosis. Monitoring of rheological variables during follow-up of patients has
been useful in gynecologic cancer; a significant increase in the main determinants
of blood viscosity was found when metastasis became clinically apparent. The most
frequent constellation in newly diagnosed cancer is an increase in plasma viscosity
(PV) and red blood cell (RBC) aggregation that produces hyperviscosity and is compensated
for by anemia. Unconditional elevation of the hematocrit in cancer can deteriorate
microcirculatory flow properties and may plunge the patient into an undesirable hemorheological
condition that limits effectiveness of cytoreductive treatment and favors dissemination
of cancer cells and the development of thrombosis. Modification of hyperviscosity,
most likely at the plasma level, may represent a concept for cancer treatment and
prevention of thrombosis. Anticoagulants and anti-inflammatory substances seem most
suitable at this point, because high fibrinogen turnover is an important determinant
of hyperviscosity in malignancy.
KEYWORDS
Hyperviscosity - cancer prognosis - anemia - thrombosis - plasma viscosity
