• World Neurosurg · Jan 2019

    Significance and prognostic value of the coagulation profile in patients with glioblastoma: implications for personalized therapy.

    • Stefania Elena Navone, Laura Guarnaccia, Marco Locatelli, Paolo Rampini, Manuela Caroli, Nicla La Verde, Chiara Gaudino, Nora Bettinardi, Laura Riboni, Giovanni Marfia, and Rolando Campanella.
    • Laboratory of Experimental Neurosurgery and Cell Therapy, Neurosurgery Unit, University of Milan, Milan, Italy.
    • World Neurosurg. 2019 Jan 1; 121: e621-e629.

    BackgroundCoagulation is an important aspect of the vascular microenvironment in which brain tumors evolve. Patients with tumor often show aberrant coagulation and fibrinolysis activation. In particular, glioblastoma (GBM), the most aggressive primary brain tumor, is associated with a state of hypercoagulability, and venous thromboembolism is a common complication of this cancer and its treatment. Our study aims to investigate the clinical and prognostic significance of routine laboratory tests to assess the coagulative state of patients with brain tumors, to identify potential new prognostic factors and targets for personalized therapy.MethodsBlood samples were collected from patients with GBM (n = 58) and patients with meningioma (MNG, n = 22), before any treatment. The parameters analyzed were prothrombin time (PT), activated partial thromboplastin time (aPTT), D dimer (DD), fibrinogen, von Willebrand factor (VWF), leukocyte count, and hemoglobin levels.ResultsPlasma levels of PT and aPTT were significantly reduced in GBMs compared with MNGs (P < 0.05), whereas DD, VWF:Ag levels, and leukocyte count were significantly higher in GBMs than in MNGs (P < 0.01). Furthermore, we observed that patients with GBM with reduced PT and aPTT and high levels of DD and VWF, defined as hypercoagulable patients, showed reduced overall survival (P < 0.05) compared with nonhypercoagulable patients.ConclusionsOur data support the assumption that patients with GBM show a plasma hypercoagulable profile and that coagulation profile is related to adverse outcome in patients with GBM. If confirmed, hypercoagulability could play an important role as a prognostic factor of the disease and in the decision of an antithrombotic prophylaxis.Copyright © 2018 Elsevier Inc. All rights reserved.

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