Annals of Hematology

, Volume 90, Issue 4, pp 447–453 | Cite as

Circulating procoagulant microparticles in cancer patients

  • Johannes Thaler
  • Cihan Ay
  • Harald Weinstabl
  • Daniela Dunkler
  • Ralph Simanek
  • Rainer Vormittag
  • Jean-Marie Freyssinet
  • Christoph Zielinski
  • Ingrid PabingerEmail author
Original Article


Accumulating evidence indicates that microparticles (MPs) are important mediators of the interaction between cancer and the hemostatic system. We conducted a large prospective cohort study to determine whether the number of circulating procoagulant MPs is elevated in cancer patients and whether the elevated MP levels are predictive of occurrence of venous thrombembolism (VTE). We analyzed plasma samples of 728 cancer patients from the ongoing prospective observational Vienna Cancer and Thrombosis Study. Study endpoint was the occurrence of symptomatic VTE. Sixty-five age- and sex-matched healthy controls were recruited for defining the cut-off point for elevated MPs (4.62 nanomolar phosphatidylserine [nM PS]), which was set at the 95th percentile of MP levels in healthy controls. The measurement of MPs was performed after capture onto immobilized annexin V, and determination of their procoagulant activity was quantified with a prothrombinase assay. During a median observation period of 710 days, 53 patients developed VTE. MP levels (nM PS) were significantly higher in cancer patients than in healthy controls (median [25th–75th percentile], 3.95 [1.74–7.96] vs. 1.19 [0.81–1.67], p < 0.001). Multivariate analysis including age, sex, surgery, chemo- and radiotherapy showed no statistically significant association of the hazard ratio of elevated MPs with VTE (0.95 [95% CI, 0.55–1.64], p = 0.856). In conclusion, MP levels were elevated in cancer patients compared to healthy individuals in this study. However, elevated MP levels were not predictive of VTE.


Microparticles Cancer Venous thromboembolism Prothrombinase assay 



Cancer and Thrombosis Study


Confidence interval




Hazard ratio


Platelet-free plasma


Nanomolar phosphatidylserine equivalent




P-selectin glycoprotein ligand


Tissue factor


Venous thromboembolism



We thank all persons that supported us in patient recruitment for the Vienna Cancer and Thrombosis Study (CATS), Silvia Koder for skillful technical assistance, and Tanja Altreiter for proof-reading of the manuscript.

Financial support

This study was supported by grants from the “Jubiläumsfonds” of the Austrian National Bank, by an unrestricted grant from Pfizer Austria, and the “Fellinger Krebsforschung”.


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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Johannes Thaler
    • 1
  • Cihan Ay
    • 1
  • Harald Weinstabl
    • 1
  • Daniela Dunkler
    • 2
  • Ralph Simanek
    • 1
  • Rainer Vormittag
    • 1
  • Jean-Marie Freyssinet
    • 4
  • Christoph Zielinski
    • 3
  • Ingrid Pabinger
    • 1
    Email author
  1. 1.Department of Medicine I, Clinical Division of Haematology and HaemostaseologyMedical University of ViennaViennaAustria
  2. 2.Center for Medical Statistics, Informatics and Intelligent Systems, Section for Clinical BiometricsMedical University of ViennaViennaAustria
  3. 3.Department of Medicine I, Clinical Division of OncologyMedical University of ViennaViennaAustria
  4. 4.Faculté de Médecine, Institut d’Hématologie & Immunologie, U. 770 INSERM Hôpital de BicêtreUniversité Paris-Sud, Le Kremlin-Bicêtre, Université Louis PasteurStrasbourgFrance

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