Haemostatic abnormalities and thrombotic disorders in malignant lymphoma

Tomohiro Sase; Hideo Wada; Motoko Yamaguchi; Shoko Ogawa; Yuko Kamikura; Masakatsu Nishikawa; Toshihiro Kaneko; Yasunori Abe; Junji Nishioka; Tsutomu Nobori; Hiroshi Shiku

doi:10.1160/TH04-04-0260

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2005; 93(01): 153-159
DOI: 10.1160/TH04-04-0260

Cellular Proteolysis and Oncology

Schattauer GmbH

Haemostatic abnormalities and thrombotic disorders in malignant lymphoma

Tomohiro Sase

¹Second Department of Internal Medicine, Mie University School of Medicine, Tsu, Japan

,

Hideo Wada

²Department of Laboratory Medicine, Mie University School of Medicine, Tsu, Japan

,

Motoko Yamaguchi

¹Second Department of Internal Medicine, Mie University School of Medicine, Tsu, Japan

,

Shoko Ogawa

¹Second Department of Internal Medicine, Mie University School of Medicine, Tsu, Japan

,

Yuko Kamikura

¹Second Department of Internal Medicine, Mie University School of Medicine, Tsu, Japan

,

Masakatsu Nishikawa

¹Second Department of Internal Medicine, Mie University School of Medicine, Tsu, Japan

,

Toshihiro Kaneko

³Department of Safety Management, Mie University School of Medicine, Tsu, Japan

,

Yasunori Abe

⁴Clinical Laboratories, Mie University Hospital, Tsu, Japan

,

Junji Nishioka

⁴Clinical Laboratories, Mie University Hospital, Tsu, Japan

,

Tsutomu Nobori

²Department of Laboratory Medicine, Mie University School of Medicine, Tsu, Japan

,

Hiroshi Shiku

¹Second Department of Internal Medicine, Mie University School of Medicine, Tsu, Japan

› Author Affiliations

Abstract

Summary

We examined haemostatic abnormalities and thrombotic disorders in 217 patients with malignant lymphoma. Plasma levels of fibrinogen and D-dimer were significantly higher in patients with malignant lymphoma than in healthy subjects.The incidence of severe complications, such as disseminated intravascular coagulation (DIC) and interstitial pneumonia (IP), differed with each clinical stage or histological type, but they occurred frequently in stage IV or natural killer (NK) cell lymphoma. Plasma levels of fibrinogen degradation products (FDP) and D-dimer, leukocyte tissue factor (TF) mRNA and plasma TF antigen were significantly higher in stage IV than in stage I, II or III. Plasma levels of FDP, D-dimer, and leukocyte TF mRNA in NK cell lymp homa were markedly higher than in other types of lymphoma. Immunohistochemical staining of NK cell lymphoma revealed that granulocyte macrophage colony-stimulating factor was positive in tumour cells, whereas von Willebrand factor and TF were positive in vascular endothelial cells of surrounding tissue. Our results suggested that patients with stage IV disease and NK cell lymphoma were in abnormal thrombotic and haemostatic state, and may frequently develop DIC and IP. One of the mechanisms of DIC and IP may involve elevated cytokine production by lymphoma cells, which can stimulate the expression of TF in blood cells or surrounding tissue.

Keywords

Malignant lymphoma - disseminated intravascular coagulation - interstitial pneumonia - thrombotic diseases - leukocyte tissue factor

Full Text

References

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