Microparticles and D-dimers improve prediction of chemotherapy-associated thrombosis in cancer patients

Abstract

Background: The cancer is associated with a state of hypercoagulability, which may be the cause of venous thromboembolism (VTE), representing an undeniable cause of morbidity and mortality. Our study aimed to investigate the role of hypercoagulability markers (D-dimers, microparticles, and V Leiden mutation) in predicting cancer-associated VTE. Methods: A prospective cohort study was conducted among cancer patients who will receive chemotherapy in the Medical Oncology and Hematology departments of the EHU of Oran, Algeria from February 2013 to May 2015, followed by an observation period of two years. First, we evaluated the risk of cancer-related VTE by hypercoagulability parameters (D-dimers, microparticles, V Leiden mutation). In the second step, we tested the predictive value of the Khorana risk score (KRS) of cancer-related VTE. Then, we developed and tested the predictive value of an expanded score based on the addition of predictive biomarkers to the KRS parameters. Results: A total of 165 patients were included in our study whose median age was 62 years. More than half were males (52.7%). After an observation period of 2 years, ten patients (6.0%) developed a VTE. Among the criteria studied, only the D-dimers and the microparticles were predictive of VTE in cancer. The positive predictive value (PPV) of the KRS was 13.6%, and the negative predictive value (NPV) was 97.9%. After adding two predictive biomarkers (D-dimers and microparticles), the expanded score had a better predictive value with a PPV of 23.5% and a VPN of 98.6%. Conclusion: The addition of hypercoagulability biomarkers (microparticles and D-dimers) to the routine clinical and biological parameters of the KRS enhances the predictive potential of VTE risk in cancer.