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Article

Prothrombotic Tendency in the Shadow of Cancer: Hypercoagulability, Impaired Clot Contraction and Fibrinolysis in Colorectal Cancer and Gastric Cancer Patients Undergoing Chemotherapy

by
Karolina Aleksandrowicz
1,2,
Tomasz Rusak
3,*,
Elżbieta Bołtromiuk
3,
Tomasz Misztal
3,
Barbara Polityńska-Lewko
4,
Anna M. Wojtukiewicz
4,
Joanna Kruszewska
5,
Marta Myśliwiec
5 and
Marek Z. Wojtukiewicz
1,*
1
Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, Waszyngtona 15 B, 15-269 Bialystok, Poland
2
Bialystok Oncology Center, Ogrodowa 12, 15-022 Bialystok, Poland
3
Department of Physical Chemistry, Medical University of Bialystok, Mickiewicza 2A, 15-222 Bialystok, Poland
4
Department of Psychology and Philosophy, Medical University of Bialystok, Szpitalna 37, 15-295 Bialystok, Poland
5
Department of Oncology, Medical University of Bialystok, Ogrodowa 12, 15-269 Bialystok, Poland
*
Authors to whom correspondence should be addressed.
Int. J. Mol. Sci. 2026, 27(4), 2037; https://doi.org/10.3390/ijms27042037
Submission received: 14 January 2026 / Revised: 13 February 2026 / Accepted: 19 February 2026 / Published: 21 February 2026
(This article belongs to the Special Issue New Advances in the Field of Thrombosis and Hemostasis)
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Abstract

Cancer is frequently accompanied by thrombotic complications, but conventional coagulation tests often fail to adequately detect cancer-associated hypercoagulability. In this study, blood from 34 patients with colorectal or gastric cancers (before, during and after 3 months of chemotherapy) and 21 healthy controls was analyzed to obtain a coagulation–fibrinolysis profile (by thromboelastometry) and determine the kinetics of clot contraction (CCR). Patients demonstrated hypercoagulable profiles characterized by shortened clotting time, enhanced clot strength, reduced CCR, and impaired fibrinolysis compared to healthy controls, which was more pronounced in colorectal cancer patients. Parameters related to increased clot formation, impaired CC and delayed fibrinolysis correlated with disease stage. Chemotherapy meaningfully prolonged fibrinolysis, which was further evident in vitro with platinum-based drugs. Our findings reveal, for the first time, a significant inhibition of CCR in cancer patients. Integrating thromboelastometry with CCR measurements may improve stratification of cancer-associated thrombotic risk, which appears to arise from the hemostatic disturbances identified in our study. These may extend the duration of clot presence due to reduced fibrinolysis, while decreasing clot stability through diminished CCR. Therefore, careful monitoring of the precarious balance between thrombotic and bleeding tendencies may hold important implications for the fate of cancer patients.
Keywords: hypercoagulability; clot contraction; fibrinolysis; cancer; chemotherapy hypercoagulability; clot contraction; fibrinolysis; cancer; chemotherapy

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MDPI and ACS Style

Aleksandrowicz, K.; Rusak, T.; Bołtromiuk, E.; Misztal, T.; Polityńska-Lewko, B.; Wojtukiewicz, A.M.; Kruszewska, J.; Myśliwiec, M.; Wojtukiewicz, M.Z. Prothrombotic Tendency in the Shadow of Cancer: Hypercoagulability, Impaired Clot Contraction and Fibrinolysis in Colorectal Cancer and Gastric Cancer Patients Undergoing Chemotherapy. Int. J. Mol. Sci. 2026, 27, 2037. https://doi.org/10.3390/ijms27042037

AMA Style

Aleksandrowicz K, Rusak T, Bołtromiuk E, Misztal T, Polityńska-Lewko B, Wojtukiewicz AM, Kruszewska J, Myśliwiec M, Wojtukiewicz MZ. Prothrombotic Tendency in the Shadow of Cancer: Hypercoagulability, Impaired Clot Contraction and Fibrinolysis in Colorectal Cancer and Gastric Cancer Patients Undergoing Chemotherapy. International Journal of Molecular Sciences. 2026; 27(4):2037. https://doi.org/10.3390/ijms27042037

Chicago/Turabian Style

Aleksandrowicz, Karolina, Tomasz Rusak, Elżbieta Bołtromiuk, Tomasz Misztal, Barbara Polityńska-Lewko, Anna M. Wojtukiewicz, Joanna Kruszewska, Marta Myśliwiec, and Marek Z. Wojtukiewicz. 2026. "Prothrombotic Tendency in the Shadow of Cancer: Hypercoagulability, Impaired Clot Contraction and Fibrinolysis in Colorectal Cancer and Gastric Cancer Patients Undergoing Chemotherapy" International Journal of Molecular Sciences 27, no. 4: 2037. https://doi.org/10.3390/ijms27042037

APA Style

Aleksandrowicz, K., Rusak, T., Bołtromiuk, E., Misztal, T., Polityńska-Lewko, B., Wojtukiewicz, A. M., Kruszewska, J., Myśliwiec, M., & Wojtukiewicz, M. Z. (2026). Prothrombotic Tendency in the Shadow of Cancer: Hypercoagulability, Impaired Clot Contraction and Fibrinolysis in Colorectal Cancer and Gastric Cancer Patients Undergoing Chemotherapy. International Journal of Molecular Sciences, 27(4), 2037. https://doi.org/10.3390/ijms27042037

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