Anna Falanga

..Available data suggest that these hemostatic markers deserve to be included in prospective clinical studies aimed at identifying their predictive role in the vascular complications of patients with ET and PV...

..Anticoagulant drugs appear to be an attractive strategy in cancer treatment because there is growing evidence for their possible benefits in terms of cancer prognosis and patient survival...

..This review summarizes the current knowledge of the epidemiology, prophylaxis, and treatment of venous thromboembolism (VTE) in patients with lymphoma, multiple myeloma or acute leukemia...

..We also review the assessment of the risk of thrombohemorrhagic events in cancer patients, and the prophylaxis and treatment of such manifestations...

..In this review we provide an overview of the principal mechanisms of thrombosis in cancer, including clinical and biological risk factors, and a summary of risk assessment tools to predict thrombosis in the single patient...

..The predictive value of these biomarkers for thrombosis remains to be established to identify subsets of patients at elevated risk who may benefit from prophylaxis with antithrombotic drugs...

..The utility of measuring MP as a diagnostic and prognostic marker is currently a subject of intense investigation. The possibility to inhibit MP production by pharmacological interventions represents a future challenge...

..In this review the principal aspects of epidemiology, risk factors and outcome of cancer-associated VTE are summarized...

..Predictive models for VTE in cancer patients are now available and will allow the possibility of improving outcomes for patients under chemotherapy by identifying those who would benefit most from thromboprophylaxis...

..More recently a number of prospective randomized clinical trials of LMWH for survival as a primary end-point in cancer patients have been conducted, showing favourable results...

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..We want to define whether this phenomenon plays a role in the formation of circulating PMN-platelet aggregates in these conditions...

..The published data are promising and provide new information in the research knowledge in this field. The potential anticancer activity of heparins is supported by data from in vitro and experimental studies...

..Further, pharmacological modulation of malignant cell hemostatic properties may not only affect the tumor-associated thrombotic risk but may also leave open the possibility to interfere with the progression of the disease...

..All of the mechanisms are not entirely understood, however research studies in the last ten years have greatly improved our knowledge of tumor-promoted pro-thrombotic functions...

..Blood. 2000;96:4261-4266)..

..Therefore, they recommend that all patients hospitalized or bedridden owing to cancer should be considered for thromboprophylaxis in the absence of contraindications to anticoagulant therapy...

..Special attention will be devoted to the new therapy with all-trans retinoic acid, which has completely changed the natural history of APL and APL-related coagulopathy...

..In this article, the various aspects of the complex relationship between thrombosis and cancer, from pathophysiology to therapy, are reviewed...

..However, in the ATRA + Tam groups, hypercoagulation markers were decreased compared with Tam alone. These results suggest that in selected conditions, pre-operative ATRA may modulate the hypercoagulable state of breast cancer patients...

..Understanding the pathophysiology of hypercoagulability is critical to the design of appropriate measures for intervention in these hematologic disorders to prevent thromboembolic complications...

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..Special attention is devoted to the use of all-trans-retinoic acid (ATRA), which has revolutionized the treatment of APL and markedly ameliorated the APL-related coagulopathy...

..Large, prospective, randomized clinical trials are needed to establish the best practice for thromboprophylaxis and treatment of VTE in these types of cancers...

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..Due to the pivotal role of coagulation activation in tumor progression, the capacity of ATRA to affect also tumor procoagulants, in parallel to cell apoptosis, open new perspectives in tumor therapy...

..The second finding is that IPF is susceptible to myelosuppressive treatment, which may additionally explain the favorable effect of hydroxyurea therapy on MPN outcome as well as the associated thrombotic risk...

..Clinical studies suggest a survival advantage in cancer patients receiving low molecular weight heparin (LMWH). A suggested mechanism for this beneficial effect may reside in the antiangiogenic activity of heparins...

..Both drugs also inhibited angiogenic response elicited by purified VEGF and FGF-2. These findings support a possible role of these molecules as adjuvant drugs in cancer treatment...

..In this study we applied a single global coagulation test, the calibrated automated thrombogram assay, to characterize the specific procoagulant phenotypes of different tumor cells...

..However, dalteparin has significantly greater effects than UFH in the microvascular endothelium, a site that plays a central role in many processes involved in inflammation and thrombosis...

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..Our data demonstrate that ET and PV are characterised by an altered pattern of soluble selectins and NOX. HU-mediated increase of NOX levels could represent an additional antithrombotic mechanism of this drug...

..05).This study demonstrates a platelet-dependent form of hypercoagulability in MPN patients, particularly in those carriers of the JAK2V617F mutation. The cytoreductive therapy with HU significantly affects this prothrombotic phenotype...

..In particular, this chapter will focus on the capacity of tumour cells to promote activation of the coagulation system, and on the mechanisms by which clotting proteins may promote tumour growth and metastasis...

..The management of VTE in cancer patients is challenging because the anticoagulant treatment in these patients can be less effective and carry considerable morbidity...

..We hope that the following report gives an idea of the event and will encourage the reader to attend the 46th meeting of the SIC, 24-26 October, 2004 in Pisa...

..The present study evaluated, for the first time, the expression of TF on platelet surface during preparation and storage of platelet concentrates (PC) for transfusional use...

..Although the results are controversial, the interest in this research area remains high...

..Decreasing the procoagulant activity and increasing the fibrinolytic potential of EC favors an anticoagulant phenotype of the endothelium, which may protect from fibrin deposition and vascular occlusion...

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..In this review, we will summarize our current knowledge of the pathogenesis of the APL-associated coagulopathy and will overview the therapeutic approaches for the management of this complication...

..Acquired and inherited risk factors for venous thromboembolism (VTE) and the incidence of symptomatic VTE were investigated in patients on adjuvant chemotherapy for breast or gastrointestinal cancer (GI)...

..We hope that better knowledge of these pathogenetic pathways will lead to the development of more targeted strategies to prevent thromboembolism in cancer patients...

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..These findings parallel the increment of NB4 surface adhesive molecules, among which VLA4 and LFA1 appear to play an important part. These mechanisms may contribute to the complications of ATRA therapy in APL...

..Eight speakers participated in the workshop. This meeting report provides synopses of their presentations and a summary of highlights from the meeting...

..However, the issue of whether screening for occult malignant disease ultimately improves prognosis and survival remains to be resolved...

..However, more studies are still needed to address this issue. This review will focus on CVC use and complications in oncohematologic patients...

..This study shows that the impact on clinical practice of symptomatic CVC-related thrombotic complications is not negligible in patients with haematological malignancies...

..Additional clinical trials are needed to provide an important step forward in this challenging setting...

..To develop guideline recommendations for the use of anticoagulation in the prevention and treatment of venous thromboembolism (VTE) in patients with cancer...