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Hämatologische oder hämostaseologische „Paraneoplasien“ als Prognosefaktoren?

Hematological or hemostaseological “paraneoplastic syndromes” as prognostic factors?

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Summary

Paraneoplastic syndromes are early but seldom appearing remote effects of tumors. In contrast, hematological or hemostaseological tumor signs can be demonstrated nearly in every tumor patient, mostly, however, after prolonged disease. The signs result from interaction between tumor and host, they depend upon the monocyte-macrophage system and are mediated by interleukin-1. Therefore, strictly speaking, they are no paraneoplasias.

By genetic instability and increasing heterogeneity, the tumor cell gradually overcomes this defence line and the clinical pictures of different metastatic diseases equalize slowly. Finally, main causes of death are equally occurring infectious and hemostaseological complications. They demonstrate the final breakdown of this defence system.

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Abbreviations

BC:

Bronchialkarzinom

βTG:

beta-Thromboglobulin

CPA:

cancer procoagulant activity

DIC:

disseminierte intravaskuläre Gerinnung

FDP:

Fibrin(ogen)-Spaltprodukte

FPA:

Fibrinopeptid A

IL-1:

Interleukin-1

PF4:

Plättchenfaktor 4

PDGF:

Plättchenwachstumsfaktor

t-PA:

Gewebstyp-Plasminogenaktivator

u-PA:

Urokinasetyp-Plasminogenaktivator

Literatur

  • Antman KH, Skarin AT, Mayer RJ, Hargreaves HK, Canellos GP (1979) Microangiopathic hemolytic anemia and cancer: a review. Medicine 58:377–384

    PubMed  Google Scholar 

  • Barrett ON (1970) Monocytosis in malignant disease. Ann Intern Med 73:991–992

    PubMed  Google Scholar 

  • Bauer KA, Rosenberg RD (1987) The pathophysiology of the prethrombotic state in humans: insight gained from studies using markers of hemostatic system activation. Blood 70:343–350

    PubMed  Google Scholar 

  • Berger H, Freudenberg N (1983) Todesursachen bei Malignompatienten. Medwelt 34:112–118

    Google Scholar 

  • Boxer MA, Braun J, Ellman L (1978) Thromboembolic risk of postsplenectomy thrombocytosis. Arch Surg 113:808–809

    PubMed  Google Scholar 

  • Cooper EH, Stone J (1979) Acute phase reactant proteins in cancer. Adv Canc Res 30:1–44

    Google Scholar 

  • Crabtree GR (1987) The molecular biology of fibrinogen. In: Stamatoyannopoulos G, Nienhuis AW, Leder Ph, Majerus PhW (Hrsg) The molecular basis of blood diseases. Saunders, Philadelphia, pp 631–661

    Google Scholar 

  • Dannenberg AM (1975) Macrophages in inflammation and infection. New Engl J Med 293:489–493

    PubMed  Google Scholar 

  • Deutsch E (1982) Blutgerinnungsstörungen bei nicht-hämatologischen malignen Erkrankungen. Beitr Onkol 13:276–289

    Google Scholar 

  • Dinarello CA (1984) Interleukin-1 and the pathogenesis of the acute phase response. New Engl J Med 311:1413–1418

    PubMed  Google Scholar 

  • Donati MB, Poggi A, Semeraro N (1981) Coagulation and malignancy. In: Poller L (Hrsg) Recent advances in blood coagulation 3. Churchill Livingstone, Edinburgh London Melbourne New York, pp 227–259

    Google Scholar 

  • Eknoyan G, Riggs SA (1986) Renal involvement in patients with thrombotic thrombocytopenic purpura. Am J Nephrol 6:117–131

    PubMed  Google Scholar 

  • Ernst E (1987) Leukozytenzahl — ein Risikoindikator kardiovaskulärer Erkrankungen? Herz/Kreisl 19:108–112

    Google Scholar 

  • Gordon SG (1985) Tumorprokoagulans, Gerinnung und Fibrinolyse bei malignen Erkrankungen. Hämostaseologie 5:160–165

    Google Scholar 

  • Grimm RH, Neaton JD, Ludwig W (1985) Prognostic importance of the white blood cell count for coronary, cancer, and all-cause mortality. JAMA 254:1932–1937

    PubMed  Google Scholar 

  • Helbig W (1980) Zur Wertigkeit paraneoplastischer Knochenmark- und Blutbildbefunde. Verh Dtsch Ges Inn Med 86:428–432

    PubMed  Google Scholar 

  • Heldin C-H, Wasteson A, Westermark B (1985) Platelet-derived growth factor. Molecular and Cellular Endocrinology 39:169–187

    PubMed  Google Scholar 

  • Heldin C-H, Betsholtz Ch, Johnsson A, Westermark B (1986) Role of PDGF-like growth factors in malignant transformation. Cancer Rev 2:34–47

    Google Scholar 

  • Hirsh J (1977) Hypercoagulability. Sem Hematol 14:409–425

    Google Scholar 

  • Kanz L, Löhr GW, Fauser AA (1987) Human megakaryocytic progenitor cells. Klin Wochenschr 65:297–307

    PubMed  Google Scholar 

  • Karpatkin S, Pearlstein E (1981) Role of platelets in tumor cell metastases. Ann Intern Med 95:636–641

    PubMed  Google Scholar 

  • Korninger C, Deutsch E (1985) The role of haemostasis in malignancy. In: Beck L, Grundmann E, Schneider W (Hrsg) The cancer patient. (Cancer campaign, vol 9, pp 79–84). Fischer, Stuttgart New York

    Google Scholar 

  • Kostis JB, Turkovich D, Sharp J (1984) Association between leukocyte count and the presence and extent of coronary atherosclerosis as determined by coronary arteriography. Am J Cardiol 53:997–999

    PubMed  Google Scholar 

  • Kressel BR, Ryan KP, Duong AT, Berenberg J, Schein PhS (1981) Microangiopathic hemolytic anemia, thrombocytopenia, and renal failure in patients treated for adenocarcinoma. Cancer 48:1738–1745

    PubMed  Google Scholar 

  • Kwaan HC (1987) Clinicopathologic features of thrombotic thrombocytopenic purpura. Sem Hematol 24:71–81

    Google Scholar 

  • Lian E C-Y (1987) Pathogenesis of thrombotic thrombocytopenic purpura. Sem Hematol 24:82–100

    Google Scholar 

  • Lovett D, Kozan B, Hadam M, Resch K, Gemsa D (1986) Macrophage cytotoxicity: interleukin 1 as a mediator of tumor cytostasis. J Immunol 136:340–347

    PubMed  Google Scholar 

  • Maat B (1980) Selective macrophage inhibition abolishes warfarin-induced reduction of metastasis. Brit J Cancer 41:313–316

    PubMed  Google Scholar 

  • Mosher DF (1980) Fibronectin. Progr Hemost Thrombos 5:111–151

    Google Scholar 

  • Munzarova M, Kovarik J (1987) Ist Krebs eine makrophagenvermittelte Autoimmunerkrankung? The Lancet (Deutsche Ausgabe) 1:571–574

    Google Scholar 

  • Nakano T, Fujii J, Tamura S, Hada T, Hagashino K (1986) Thrombocytosis in patients with malignant pleural mesothelioma. Cancer 58:1699–1701

    PubMed  Google Scholar 

  • Odell WD, Wolfsen AR (1978) Humoral syndromes associated with cancer. Ann Rev Med 29:379–406

    PubMed  Google Scholar 

  • Rasche H (1985) Hämostasedefekte durch Umsatzstörungen bei soliden Tumoren und malignen hämatologischen Systemerkankungen. In: Heene DL (Hrsg) Handbuch der Inneren Medizin, Bd 2, Teil 9: Blutgerinnung und hämorrhagische Diathesen II, Springer, Berlin Heidelberg New York, S. 650–674

    Google Scholar 

  • Rickles FR, Edwards RL (1983) Activation of blood coagulation in cancer. Trousseau's syndrome revisited. Blood 62:14–31

    PubMed  Google Scholar 

  • Ross R (1986) The pathogenesis of atherosclerosis — an update. New Engl J Med 314:488–500

    PubMed  Google Scholar 

  • Scharf RE (1986) Thrombozyten und Mikrozirkulationsstörungen. Klinische und experimentelle Untersuchungen zum Sekretionsverhalten und Arachidonsäurestoffwechsel der Blutplättchen. Schattauer, Stuttgart New York

    Google Scholar 

  • Schmitz-Huebner U, van de Loo J (1982) Differentialdiagnose von Hyperkoagulabilität, Hyperfibrinolyse und disseminierter intravasaler Gerinnung bei malignen Erkrankungen. Beitr Onkol 13:266–275

    Google Scholar 

  • Schneider W (1987a) Bedeutung von Hämostasestörungen für Diagnostik und Therapie von Tumorkrankheiten. Hämostaseologie (im Druck)

  • Schneider W (1987b) Ist Thrombozytose ein Tumorzeichen? Internist prax (im Druck)

  • Schneider W (1987c) Tumor, Thrombozytose und Thrombosegefährdung. Dtsch Med Wochenschr (im Druck)

  • Schneider W, Kliche O (1987) 2-h-Wert der Blutkörperchensenkung. internist prax 27:453–454

    Google Scholar 

  • Schneider W, Winkelmann M (1985) Hematological tumor signs. In: Beck L, Grundmann E, Schneider W (Hrsg) The cancer patient. Cancer campaign, vol 9, S 71–77) Fischer, Stuttgart New York

    Google Scholar 

  • Schwartz CJ, Valente AJ, Sprague EA, Kelly JL, Suenram CA, Graves DT, Rozek MM, Edwards EH, Delgado R (1986) Monocyte-makrophage participation in atherogenesis: inflammatory components of pathogenesis. Sem Thromb Hemostas 12:79–86

    Google Scholar 

  • Snipper LE (1986) Clinical implications of tumor cell heterogeneity. New Engl J Med 314:1423–1431

    PubMed  Google Scholar 

  • Stossel ThP (1987) The molecular biology of phagocytes and the molecular basis of nonneoplastic phagocyte disorders. S 499–533. In: Stamatoyannopoulos G, Nienhuis AW, Leder Ph, Majerus PhW (Hrsg) The molecular basis of blood diseases. Saunders, Philadelphia

    Google Scholar 

  • Trousseau A (1865) Phlegmasia alba dolens. In: Clinique medicale de L'Hotel-Dieu de Paris. Balliere 3:654–656

    Google Scholar 

  • Virelizier JL, Arenzana-Seisdedos F (1985) Immunological functions of macrophages and their regulation by interferons. Med Biol 63:149–159

    PubMed  Google Scholar 

  • Wilmanns W, Possinger K (1986) Paraneoplastische Syndrome — eine Hilfe bei der Früherkennung maligner Tumoren? Verh Dtsch Ges Inn Med 92:66–76

    PubMed  Google Scholar 

  • Winkelmann M, Pfitzer P, Schneider W (1987) Polyploidy of cells and tissues in relation to the ploidy of megakaryocytes. Klin Wochenschr (im Druck)

  • Zacharski LR (1985) Biologische Grundlagen einer Antikoagulantienbehandlung bei Tumorkrankheiten. Hämostaseologie 5:178–184

    Google Scholar 

  • Zöllner N (1986) Der leise Beginn chronischer Krankheiten — Beiträge zu ihrer Frühsymptomatologie und zur Nosologie der Frühstadien — Einführung. Verh Dtsch Ges Inn Med 92:1–2

    Google Scholar 

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Authors and Affiliations

  1. Medizinische Klinik und Poliklinik, Universität Düsseldorf, Germany

    W. Schneider

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  1. W. Schneider
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Herrn Prof. Dr. N. Zöllner, München, zum 65. Geburtstag gewidmet

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Schneider, W. Hämatologische oder hämostaseologische „Paraneoplasien“ als Prognosefaktoren?. Klin Wochenschr 66, 103–109 (1988). https://doi.org/10.1007/BF01774223

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