Coagulation in Cancer

Volume 148 of the series Cancer Treatment and Research pp 31-41


Activation of Clotting Factors in Cancer

  • Frederick R. RicklesAffiliated withDivision of Hematology-Oncology, Department of Medicine, The George Washington University Email author 
  • , Anna Falanga

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Evidence for “hypercoagulability” is commonly found in patients with cancer and increases the risk of thromboembolism (TE) [1]. While the pathophysiology of TE in cancer is complex, it can be viewed classically as related to abnormalities of Virchow’s triad: stasis of the blood; vascular injury; hypercoagulability (or, as described by Virchow himself, as “abnormalities of the fixed elements of the blood”) [2]. Epidemiologic, laboratory, pathologic and clinical evidence supports this important association. However, association is clearly not the same as causation and, until recently, TE was thought largely to be an epiphenomenon in cancer – a secondary manifestation of the inflammatory response to tumor growth and/or to the therapy (e.g. chemotherapy, surgery, radiation therapy).