Associations between hematopoietic growth factors and risks of venous thromboembolism, stroke, ischemic heart disease and myelodysplastic syndrome: findings from a large population-based cohort of women with breast cancer

Du, Xianglin L.; Zhang, Yefei; Hardy, Dale S.

doi:10.1007/s10552-016-0742-5

Cited by 8 publications

(5 citation statements)

References 35 publications

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“…The use of CSFs and ESAs has definitely improved the effectiveness of chemotherapy treatments, although several observational and randomized studies have indicated that these HGFs had some short- and long-term side effects in several cancer pathologies (120,121). Among these side-effects are venous thromboembolism (VTE), stroke, ischemic heart disease and AML or myelodysplastic syndrome (MDS) in patients with various types of cancer, including breast cancer (120-122).…”

Section: Pathophysiologymentioning

confidence: 99%

“…Du and Zhang (2015) and Du et al (2016) evaluated the association between the use of CSFs and ESAs and the increased risk of VTE, stroke, ischemic heart disease and AML/MDS onset in patients with breast and colorectal cancers (120,121). These authors demonstrated that patients with colorectal cancer treated with chemotherapy combined with CSFs and ESAs had an increased risk of MDS, VTE and to a lesser extent, an increased risk of ischemic heart disease (120).…”

Section: Pathophysiologymentioning

confidence: 99%

“…These authors demonstrated that patients with colorectal cancer treated with chemotherapy combined with CSFs and ESAs had an increased risk of MDS, VTE and to a lesser extent, an increased risk of ischemic heart disease (120). With regards to breast cancer patients, the retrospective cohort study by Du et al demonstrated that the combination of chemotherapy, CSFs and ESAs was associated with a 2-fold increased risk of developing VTE (2.01 hazard ratio) and AML/MDS (4.55 hazard ratio) and a weak increased risk of ischemic heart disease (1.08 hazard ratio), while the use of both CSFs and ESAs was not associated with an increased risk of stroke (121). These two studies demonstrated that the use of HGFs was not associated with the risk of stroke in cancer patients.…”

Section: Pathophysiologymentioning

confidence: 99%

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Cancer-associated stroke: Pathophysiology, detection and management (Review)

et al. 2019

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Numerous types of cancer have been shown to be associated with either ischemic or hemorrhagic stroke. In this review, the epidemiology and pathophysiology of stroke in cancer patients is discussed, while providing vital information on the diagnosis and management of patients with cancer and stroke. Cancer may mediate stroke pathophysiology either directly or via coagulation disorders that establish a state of hypercoagulation, as well as via infections. Cancer treatment options, such as chemotherapy, radiotherapy and surgery have all been shown to aggravate the risk of stroke as well. The clinical manifestation varies greatly depending upon the underlying cause; however, in general, cancer-associated strokes tend to appear as multifocal in neuroimaging. Furthermore, several serum markers have been identified, such as high D-Dimer levels and fibrin degradation products. Managing cancer patients with stroke is a delicate matter. The cancer should not be considered a contraindication in applying thrombolysis and recombinant tissue plasminogen activator (rTPA) administration, since the risk of hemorrhage in cancer patients has not been reported to be higher than that in the general population. Anticoagulation, on the contrary, should be carefully examined. Clinicians should weigh the benefits and risks of anticoagulation treatment for each patient individually; the new oral anticoagulants appear promising; however, low-molecular-weight heparin remains the first choice. On the whole, stroke is a serious and not a rare complication of malignancy. Clinicians should be adequately trained to handle these patients efficiently.

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Section: Pathophysiologymentioning

confidence: 99%

Section: Pathophysiologymentioning

confidence: 99%

Section: Pathophysiologymentioning

confidence: 99%

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Cancer-associated stroke: Pathophysiology, detection and management (Review)

et al. 2019

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“…Out of 22 studies that reported the combined incidence of ischemic and hemorrhagic stroke at 1 year, eight were cohort studies that included multiple types of cancer ( Supplementary Figure 3 ) ( 12 , 14 , 15 , 25 , 27 , 31 , 33 , 34 ). The remaining 14 studies were limited to specific cancer subtypes including head and neck cancer ( n = 3) ( 16 , 24 , 28 ), hematologic malignancies ( n = 2) ( 19 , 29 ), breast cancer ( n = 2) ( 21 , 23 ), and thyroid cancer ( n = 2) ( 26 , 32 ). There was only one study for each of the following subtypes of cancer: pancreatic, cervical, prostate, colorectal, and hepatic ( 17 , 18 , 20 , 22 , 30 ).…”

Section: Resultsmentioning

confidence: 99%

Incidence of stroke in the first year after diagnosis of cancer—A systematic review and meta-analysis

Lun

Deka

et al. 2022

Front. Neurol.

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BackgroundPatients newly diagnosed with cancer represent a population at highest risk for stroke. The objective of this systematic review and meta-analysis was to estimate the incidence of stroke in the first year following a new diagnosis of cancer.MethodsWe searched MEDLINE and EMBASE from January 1980 to June 2021 for observational studies that enrolled adults with a new diagnosis of all cancers excluding non-melanoma skin cancer, and that reported the incidence of stroke at 1 year. PRISMA guidelines for meta-analyses were followed. Two reviewers independently extracted data and appraised risk of bias. We used the Dersimonian and Laird random effects method to pool cumulative incidences after logit transformation, and reported pooled proportions as percentages. Statistical heterogeneity was assessed using the I2 statistic.ResultsA total of 12,083 studies were screened; 41 studies were included for analysis. Data from 2,552,121 subjects with cancer were analyzed. The cumulative incidence of total stroke at 1 year was 1.4% (95% CI 0.9–2.2%), while the pooled incidence of ischemic stroke was 1.3% (95% CI 1.0–1.8%) and 0.3% (95% CI 0.1–0.9%) for spontaneous intracerebral hemorrhage (ICH), with consistently high statistical heterogeneity (>99% I2).ConclusionThe estimated incidence of stroke during the first year after a new diagnosis of cancer is 1.4%, with a higher risk for ischemic stroke than ICH. Cancer patients should be educated on the risk of stroke at the time of diagnosis. Future studies should evaluate optimal primary prevention strategies in this high-risk group of patients.Systematic review registrationhttps://osf.io/ucwy9/.

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“…(P <0.0001) (21). Since then, a series of studies have demonstrated that the application of G-CSF is associated with an increased risk of VTE in patients with gastroesophageal (30), colorectal (31), breast (32), and comprehensive cancers (33).…”

Section: Figurementioning

confidence: 99%

Role of recombinant human granulocyte colony-stimulating factor in development of cancer-associated venous thromboembolism in lung cancer patients who undergo chemotherapy

Cheng,

Zhao,

et al. 2024

Front. Immunol.

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BackgroundThe role of recombinant human granulocyte colony-stimulating factor (rhG-CSF), especially the long-acting factor in the development of cancer-associated venous thromboembolism (VTE) in lung cancer patients who undergo chemotherapy has been understudied, although the use of rhG-CSF has been reported to be associated with an increased risk of VTE.MethodsWe retrospectively reviewed 1,673 lung cancer patients who underwent hospitalized chemotherapy. We performed propensity score matching to offset confounding factors related to cancer-associated VTE development and classified the patients into short-acting (N = 273), long-acting (N = 273), and no rhG-CSF (N = 273) groups. The primary outcome was cumulative cancer-associated VTE development three months after all cycles of chemotherapy.ResultsThe overall VTE incidence in the short-acting, long-acting, and no rhG-CSF groups was 5.5%, 10.3%, and 2.2%, respectively (P <0.001). The VTE incidence in the long-acting rhG-CSF group was higher than that in the short-acting (P = 0.039) and no rhG-CSF groups (P <0.001). The VTE incidence in the short-acting rhG-CSF group was higher than that in the no rhG-CSF group (P = 0.045). The use of rhG-CSF (hazard ratio [HR] 2.337; 95% confidence interval [CI] [1.236–5.251], P = 0.006) was positively correlated with VTE development among all patients, whereas the use of long-acting rhG-CSF (HR 1.917, 95% CI [1.138–4.359]; P = 0.016), was positively correlated with VTE development in patients receiving rhG-CSF.ConclusionThe use of rhG-CSF, especially long-acting rhG-CSF, increases the risk of cancer-associated VTE development compared to no rhG-CSF use in lung cancer patients who undergo hospitalized chemotherapy.

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Associations between hematopoietic growth factors and risks of venous thromboembolism, stroke, ischemic heart disease and myelodysplastic syndrome: findings from a large population-based cohort of women with breast cancer

Abstract: Receipts of CSFs and ESAs were significantly associated with an increased risk of VTE in women with breast cancer. Use of ESAs was significantly associated with substantially increased risks of MDS. These findings support those of previous studies.

Cited by 8 publications

References 35 publications

Cancer-associated stroke: Pathophysiology, detection and management (Review)

Cancer-associated stroke: Pathophysiology, detection and management (Review)

Incidence of stroke in the first year after diagnosis of cancer—A systematic review and meta-analysis

Role of recombinant human granulocyte colony-stimulating factor in development of cancer-associated venous thromboembolism in lung cancer patients who undergo chemotherapy

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