Antiphosplipid Antibodies and Thrombosis in Cancer Patients.

Abstract 5071

Antiphospholipid antibodies,Abs are common in hospitalized patients,particularly with cancer and acquired human virus immunodeficieny HIV/AIDS. The role of antiphospholipid antibodies in deep vein thrombosis DVT, pulmonary embolism PE and thrombocytopenia is underestimated in clinical practice. The matter is also complicated by many other confounding factors affecting the interpretation of the result for lupus anticoagulant LAC; a coagulation/qualitative test and ELISA test for anticardiolipin antibodies(quantitative). Anticoagulation therapy, presence of antithrombin antibodies, coagulation factors deficiency, the lag time between collection of blood and testing, reagent used and the dilution are all contributing to the accuracy of results. In this study all patients with cancer and thrombosis, thrombocytopenia with coagulopathy not related to coumadin or disseminated intravascular coagulopathy or coagulation factors deficiency were tested for antiphospholipid antibodies. A total of three hundred patients over a year period were randomly selected. All patients were consulted for hematological evaluation. Fifty patients had thrombotic events. this include DVT with or without PE. Eighty percent had cancer. Twenty percent had other problems including HIV infection or AIDS. Female:male ratio is 1:1. Fifty percent were LAC positive with moderately to high titers for phospholipid antibodies. Thirty percent were LAC borderline with discordant results for ELISA anticardiolipin antibodies IgG and IgM. All patients had negative workup for other hypercoagulability panel. This study was done at a single institution with limited internal bias regarding ordering physician. In conclusion: This study indicates the impact of antiphospholipid antibodies in the pathophysiology of thrombosis. Larger prospective multicenter trials needed to confirm this fact.