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Cancers 2019, 11(1), 100; https://doi.org/10.3390/cancers11010100

Thrombin Generation and Cancer: Contributors and Consequences

1
ANZAC Research Institute, University of Sydney, Concord 2139, Australia
2
Department of Haematology, Singapore General Hospital, Singapore 169608, Singapore
3
Department of Haematology, Concord Hospital, Concord 2139, Australia
*
Author to whom correspondence should be addressed.
Received: 1 December 2018 / Revised: 4 January 2019 / Accepted: 8 January 2019 / Published: 16 January 2019
(This article belongs to the Special Issue The Role of Thrombosis and Haemostasis in Cancer)
Full-Text   |   PDF [608 KB, uploaded 16 January 2019]   |  

Abstract

The high occurrence of cancer-associated thrombosis is associated with elevated thrombin generation. Tumour cells increase the potential for thrombin generation both directly, through the expression and release of procoagulant factors, and indirectly, through signals that activate other cell types (including platelets, leukocytes and erythrocytes). Furthermore, cancer treatments can worsen these effects. Coagulation factors, including tissue factor, and inhibitors of coagulation are altered and extracellular vesicles (EVs), which can promote and support thrombin generation, are released by tumour and other cells. Some phosphatidylserine-expressing platelet subsets and platelet-derived EVs provide the surface required for the assembly of coagulation factors essential for thrombin generation in vivo. This review will explore the causes of increased thrombin production in cancer, and the availability and utility of tests and biomarkers. Increased thrombin production not only increases blood coagulation, but also promotes tumour growth and metastasis and as a consequence, thrombin and its contributors present opportunities for treatment of cancer-associated thrombosis and cancer itself. View Full-Text
Keywords: cancer; thrombosis; thrombin generation; platelets; procoagulant platelets; extracellular vesicles; neutrophil extracellular traps cancer; thrombosis; thrombin generation; platelets; procoagulant platelets; extracellular vesicles; neutrophil extracellular traps
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Reddel, C.J.; Tan, C.W.; Chen, V.M. Thrombin Generation and Cancer: Contributors and Consequences. Cancers 2019, 11, 100.

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