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We always knew GBM patients had a higher chance of developing blood clots in the legs and lungs... but never knew why. This article may have the answer.
Thromb Haemost. 2013 Jun 27;110(2). [Epub ahead of print]
Circulating microparticles of glial origin and tissue factor bearing in high-grade glioma: a potential prothrombotic role.
Sartori MT, Della Puppa A, Ballin A, Campello E, Radu CM, Saggiorato G, d'Avella D, Scienza R, Cella G, Simioni P.
Maria Teresa Sartori, MD, 2nd Chair of Internal Medicine, Department of Cardiologic, Thoracic and Vascular Sciences, via Giustiniani 2, 35128 Padova, Italy, Tel.: +39 049 8212653; Fax: +39 049 8218731, E-mail: mtsart@unipd.it.
Abstract
Venous thromboembolism (VTE) may complicate the clinical course of glioblastoma multiforme (GBM). Circulating microparticles (MPs) have been associated with cancer-related VTE. Sixty-one consecutive patients with GBM undergoing gross-total (41) or subtotal (20) surgical resection followed by radio-chemotherapy were prospectively evaluated. MPs numbers according to cellular origin and the procoagulant activity of annexin V positive (AV+) MPs (MP-activity) were measured before surgery and then 1 week and 1, 4, and 7 months after surgery. Glial (GFAP+) and endothelial (CD62E+) derived MPs, AV+ and tissue factor-bearing (TF+) MPs were measured using flow cytometry. Baseline levels of GFAP+/TF-, TF+/GFAP-, and GFAP+/TF+ MPs were significantly higher in GBM patients than in healthy controls, and significantly increased at each time point after surgery; at 7 months, a further significant increase over the level found a week after surgery was only seen in the subtotally resected patients. The number AV+/CD62E- MPs increased in GBM patients and correlated with MP activity. TF+/GFAP- MPs numbers were significantly higher in 11 GBM patients who developed VTE than in those who did not (p 0.04). TF+/GFAP- MPs levels above the 90th percentile (calculated in GBM patients without VTE) were associated with a higher risk of VTE (RR 4.17, 95% CI 1.57-11.03). In conclusion, the numbers of glial-derived and/or TF-bearing MPs were high in GBM patients both before and even more after the neoplasm was treated, especially in patients with subtotal resection likely according to disease progression. A contribution of TF+/GFAP- MPs to the risk of VTE is suggested.