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Semin Thromb Hemost 2009; 35(7): 644-653
DOI: 10.1055/s-0029-1242718
© Thieme Medical Publishers

The Bidirectional Relationship of Cancer and Hemostasis and the Potential Role of Anticoagulant Therapy in Moderating Thrombosis and Cancer Spread

Massimo Franchini1 , Martina Montagnana2 , Emmanuel J. Favaloro3 , Giuseppe Lippi4
  • 1Immunohematology and Transfusion Center, Department of Pathology and Laboratory Medicine University Hospital of Parma, Parma
  • 2Section of Clinical Chemistry, Department of Biomedical and Morphological Sciences, University of Verona, Verona; Italy
  • 3Department of Haematology, Institute of Clinical Pathology and Medical Research (ICPMR), Westmead Hospital, Westmead, Australia
  • 4U.O. Diagnostica Ematochimica, Dipartimento di Patologia e Medicina di Laboratorio, Azienda Ospadaliero-Universitaria di Parma, Parma, Italy
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Publication History

Publication Date:
09 December 2009 (online)

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ABSTRACT

The relationship between hemostasis and malignancy is well recognized, with both elements interacting in a “vicious cycle” where cancers overexpress procoagulants and thrombin, which in turn promote both prothrombotic potential and tumor growth, invasion, and spread. Indeed, venous thromboembolism, particularly idiopathic venous thrombosis, occurs frequently as a paraneoplastic phenomenon, and in turn several components of primary and secondary hemostasis (namely platelets, tissue factor, and thrombin) play an important role in primary tumor growth and metastasization. Despite the many and various mechanisms involved in this multifaceted relationship, anticoagulants might represent an attractive anticancer therapy, in that current research supports the hypothesis that such drugs may offer a better control of cancer progression. The main biological and clinical evidence on the relationship between cancer and hemostasis are briefly summarized in this review, as is the potential benefits of anticoagulant therapy in this setting.

KEYWORDS

Cancer - hemostasis - anticoagulant therapy

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Massimo FranchiniM.D. 

Immunohematology and Transfusion Center, Department of Pathology and Laboratory Medicine

University Hospital of Parma, Parma, Italy

Email: massimo.franchini@azosp.vr.it