Hemophilia and cancer: A new challenge for hemophilia centers

Franchini, Massimo; Lippi, Giuseppe; Montagnana, Martina; Targher, Giovanni; Zaffanello, Marco; Salvagno, Gian Luca; Rivolta, Gianna Franca; Perna, Caterina Di; Tagliaferri, Annarita

doi:10.1016/j.ctrv.2009.01.001

Cited by 41 publications

(49 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In VWD patients, the management of cancer remains a challenge for physicians. Diagnostic and elective procedures may require proper replacement therapy, and the fact that thrombocytopenia is a well-known side-effect of chemotherapy means that more treatment of VWD might be needed to prevent or treat a bleed [39].…”

Section: Discussionmentioning

confidence: 99%

von Willebrand disease and aging: an evolving phenotype

Sanders

Giezenaar

Gorkom

et al. 2014

Journal of Thrombosis and Haemostasis

136

View full text Add to dashboard Cite

Summary. Background: Because the number of elderly von Willebrand disease (VWD) patients is increasing, the pathophysiology of aging in VWD has become increasingly relevant. Objectives: To assess age-related changes in von Willebrand factor (VWF) and factor VIII (FVIII) levels and to compare age-related differences in bleeding phenotype between elderly VWD patients and those < 65 years. We also studied co-morbidity in elderly patients. Patients/ Methods: We included VWD patients with VWF levels ≤ 30 U dL À1 in the nationwide cross-sectional 'Willebrand in the Netherlands' (WiN-) study. Patients reported bleeding episodes and treatment of VWD in the year preceding inclusion and during life. This was compared between VWD patients older (n = 71) and younger (16-64 years, n = 593) than 65 years. In elderly patients, agerelated changes in VWF and FVIII levels were studied longitudinally by including all historically measured levels. All medical records were examined for co-morbidity. Results: In elderly type 1 patients, a decade age increase was associated with a 3.5 U dL À1 (95% CI, À0.6 to 7.6) VWF:Ag increase and 7.1 U dL À1 (95% CI, 0.7 to 13.4) FVIII:C increase. This increase was not observed in elderly type 2 patients. Elderly type 2 patients reported significantly more bleeding symptoms in the year preceding inclusion than younger patients (16/27, 59% vs. 87/ 221, 39%; P = 0.048), which was not observed in type 1 VWD. Conclusions: von Willebrand factor parameters and bleeding phenotype evolve with increasing age in VWD. VWF and FVIII levels increase with age in type 1 patients with no mitigation in bleeding phenotype. In type 2 patients VWF parameters do not increase with age and in these patients aging is accompanied by increased bleeding.

show abstract

Section: Discussionmentioning

confidence: 99%

von Willebrand disease and aging: an evolving phenotype

Sanders

Giezenaar

Gorkom

et al. 2014

Journal of Thrombosis and Haemostasis

136

View full text Add to dashboard Cite

show abstract

“…45 It is uncertain whether or not this is also true in humans. 46 Two population studies found a lower incidence of cancer, particularly in patients with severe hemophilia, 4,7 but the prevalence of tumors other than HCC and non-Hodgkin lymphoma was 4-fold higher than in the age-matched general population in a small study of elderly PWHs. 47 Literature data on the treatment of cancer in elderly PWHs are limited to a few case reports, so that there is no evidence-based recommendation for the optimal management of these cases.…”

Section: Age-related Diseases In Elderly Persons With Hemophilia Cancermentioning

confidence: 99%

How I treat age-related morbidities in elderly persons with hemophilia

Mannucci

Schutgens

Santagostino

et al. 2009

Blood

165

191

View full text Add to dashboard Cite

In persons with hemophilia, life expectancy is now approaching that of the general male population, at least in countries that can afford regular replacement therapy with coagulation factor concentrates. The new challenges for comprehensive treatment centers are thus to provide optimal health care for this aging population of patients, who often present not only with the comorbidities typically associated with hemophilia (arthropathy, chronic pain, blood-borne infections), but also with common age-related illnesses such as cardiovascular disease and cancer. There are no evidence-based guidelines for the management of these conditions, which often require drugs that interfere with hemostasis, enhance the bleeding tendency, and warrant more intensive replacement therapy. At the moment, elderly patients with hemophilia affected by other diseases should be managed like their age-group peers without hemophilia, provided replacement therapy is tailored to the heightened risk of bleeding associated with the need for invasive procedures and drugs that further compromise the deranged hemostasis. More detailed advice is provided on the schedules of replacement therapy needed to tackle cardiovascular diseases, such as acute coronary syndromes and nonvalvular atrial fibrillation, because these conditions will become more and more frequent challenges for the comprehensive treatment centers. (Blood. 2009;114: 5256-5263)

show abstract

“…However, in our study, the vessels stained by vWf did not predict better prognosis. Some other studies have suggested that the interaction between tumor cells and coagulation cascade factors (such as vWf) and/or platelets might promote invasiveness and metastasis capacity of cancer cells [20,[41][42][43][44]. Hence, the role of blood and lymphatic vessels in cancers remains unsolved, and additional studies are needed.…”

Section: Discussionmentioning

confidence: 95%

High relative density of lymphatic vessels predicts poor survival in tongue squamous cell carcinoma

Seppälä

Pohjola

Laranne

et al. 2016

Eur Arch Otorhinolaryngol

View full text Add to dashboard Cite

Tongue cancer has a poor prognosis due to its early metastasis via lymphatic vessels. The present study aimed at evaluating lymphatic vessel density, relative density of lymphatic vessel, and diameter of lymphatic vessels and its predictive role in tongue cancer. Paraffin-embedded tongue and lymph node specimens (n = 113) were stained immunohistochemically with a polyclonal antibody von Willebrand factor, recognizing blood and lymphatic endothelium and with a monoclonal antibody podoplanin, recognizing lymphatic endothelium. The relative density of lymphatic vessels was counted by dividing the mean number of lymphatic vessels per microscopic field (podoplanin) by the mean number of all vessels (vWf) per microscopic field. The high relative density of lymphatic vessels (≥80 %) was associated with poor prognosis in tongue cancer. The relative density of lymphatic vessels predicted poor prognosis in the group of primary tumor size T1-T2 and in the group of non-metastatic cancer. The lymphatic vessel density and diameter of lymphatic vessels were not associated with tongue cancer survival. The relative density of lymphatic vessels might have clinically relevant prognostic impact. Further studies with increased number of patients are needed.

show abstract

Hemophilia and cancer: A new challenge for hemophilia centers

Cited by 41 publications

References 24 publications

von Willebrand disease and aging: an evolving phenotype

von Willebrand disease and aging: an evolving phenotype

How I treat age-related morbidities in elderly persons with hemophilia

High relative density of lymphatic vessels predicts poor survival in tongue squamous cell carcinoma

Contact Info

Product

Resources

About