Measurement of Prothrombin Time, Activated Partial Thromboplastin Time and VIII Activity in a Sample of Iraqi Patients with Solid Tumors View PDF

Maysaa Awadh Bahaeadeen
Department Of Hematology, Hematology And Bone Marrow Transplantation Center, Baghdad Medical Mity Momplex, Ministry Of Health, Baghdad, Iraq
Ikbal Mohammed Hachim AL-Maadheed
Department Of Hematology, Hematology And Bone Marrow Transplantation Center, Baghdad Medical Mity Momplex, Ministry Of Health, Baghdad, Iraq
Eman Qassim Ahmed
Medicine, Teaching Laboratories, Baghdad Medical City, Ministry Of Health, Baghdad, Iraq
Dalya Gheni Saber
Medicine, Al-numan Teaching Hospital, Ministry Of Health, Baghdad, Iraq

Published on: 2025-07-18

Abstract

Acquired thrombophilia is associated with a considerable risk of thrombosis which is highly encountered in malignancy, where both venous and arterial thromboembolism are not uncommon complications. Patients with malignant tumors, also present with hypercoagulability, even in the lack of thrombosis. Besides, activation of coagulation pathway may play a part in tumor progression. Around 15% of all patients with malignancy develops thrombosis during the course of their disease. Thrombosis can affect the morbidity and mortality of the underlying illness. Furthermore, complications of Thrombosis are one of the most common causes of death in patients with malignant tumors. Therefore, preventing thrombotic complications in cancer patients is a clinically significant concern. To study the effect of solid malignant tumors on blood coagulation via measurements of prothrombin time (PT), activated partial thromboplastin time (APTT) and factor VIII activity. Thirty patients diagnosed with malignant tumors attending the oncology consolatory out-patient clinic at Baghdad teaching hospital were investigated versus a control group of 30 healthy donors. PT, APTT and factor VIII activity were estimated, PT and APTT assessed by semi-automated technique and factor VIII activity was measured by clotting method. PT and APTT results were insignificantly related to control group 13.037 (±0.651) vs. 13.433 (±0.43) respectively. There was a significant correlation between PT with the stage of the malignant tumors. There was statistically significant difference in mean factor VIII activity between the patients and control group (p < 0.000). There was increase in factor VIII activity in cancer patients compared to the control group reflecting subclinical thrombophilia and higher risk of Venous thromboembolism (VTE) in patients with solid tumors due to activation of both prothrombotic and fibrinolytic pathways by malignant cells which is vital to consider primary prophylaxis by anticoagulants.

Keywords

Prothrombin time, Activated partial thromboplastin time, Factor VIII, Thrombophilia, Solid tumors

Introduction

It is estimated that VTE disease occurs in about 6.8% of patients with an underlying malignancy [1, 2, 3]. A constellation of factors rather than a single event contributes to the hypercoagulable state of cancer. Chemotherapy, surgery, immobilization, and the presence of comorbid conditions are associated with increased risk of clotting in these patients. However, the leading factor that predisposes cancer patients to thrombosis seems to be related to the interaction of tumor cells with the hemostatic system. Cancer cells possess a host of procoagulant properties mediated through excessive release of angiogenic factors, cytokine release as well as direct effect on the vessel wall [1, 4].

Thrombotic events can influence the morbidity and mortality of the underlying disease. Thrombotic complications are among the most common causes of death in patients with cancer. Therefore, preventing these complications in cancer patients is a clinically relevant issue. Recently, new approaches to the prevention and cure of thrombosis in cancer have been investigated, and the hypothesis that the strategies to inhibit clotting mechanism may favorably affect malignant disease is gaining increasing interest [2, 5, 6]. The study aimed to assess the effect of solid malignant tumors on blood coagulation via measurements of PT, APTT and factor VIII activity.