Paraneoplastic Thrombocytosis in Ovarian Cancer

• Published in: The New England journal of medicine Vol. 366; no. 7; pp. 610 - 618
• Main Authors: Stone, Rebecca L, Nick, Alpa M, McNeish, Iain A, Balkwill, Frances, Han, Hee Dong, Bottsford-Miller, Justin, Rupaimoole, Rajesha, Armaiz-Pena, Guillermo N, Pecot, Chad V, Coward, Jermaine, Deavers, Michael T, Vasquez, Hernan G, Urbauer, Diana, Landen, Charles N, Hu, Wei, Gershenson, Hannah, Matsuo, Koji, Shahzad, Mian M.K, King, Erin R, Tekedereli, Ibrahim, Ozpolat, Bulent, Ahn, Edward H, Bond, Virginia K, Wang, Rui, Drew, Angela F, Gushiken, Francisca, Collins, Katherine, DeGeest, Koen, Lutgendorf, Susan K, Chiu, Wah, Lopez-Berestein, Gabriel, Afshar-Kharghan, Vahid, Sood, Anil K
• Format: Journal Article
• Language: English
• Published: Waltham, MA Massachusetts Medical Society 16.02.2012
• Subjects: Angiogenesis; Animal models; Animals; Antibodies, Monoclonal - therapeutic use; Biological and medical sciences; Blood Platelets - immunology; Cancer; Cell adhesion & migration; Cytokines; Data processing; Disease Models, Animal; Disease-Free Survival; Female; Female genital diseases; General aspects; Gynecology. Andrology. Obstetrics; Hematologic and hematopoietic diseases; Humans; Interleukin 6; Interleukin-6 - antagonists & inhibitors; Interleukin-6 - blood; Interleukin-6 - immunology; Kaplan-Meier Estimate; Medical sciences; Mice; Mice, Knockout; Multivariate analysis; Neoplasms, Glandular and Epithelial - blood; Neoplasms, Glandular and Epithelial - complications; Neoplasms, Glandular and Epithelial - drug therapy; Ovarian cancer; Ovarian Neoplasms - blood; Ovarian Neoplasms - complications; Ovarian Neoplasms - drug therapy; Paclitaxel; Paracrine signalling; Paraneoplastic Syndromes; Patients; Plasma levels; Platelet Count; Platelet diseases and coagulopathies; Platelets; Proportional Hazards Models; Receptors, Interleukin-6 - deficiency; Signal Transduction; Thrombocytosis; Thrombocytosis - etiology; Thrombopoietin; Thrombopoietin - antagonists & inhibitors; Thrombopoietin - blood; Tumors; United Kingdom > UK; United States > US; Medicine; Ovarian diseases; Platelet; Ovary cancer; Thrombocytosis; Hemopathy; Paraneoplastic syndrome; Malignant tumor; Cancer; Female genital diseases
• ISSN: 0028-4793; 1533-4406; 1533-4406
• DOI: 10.1056/NEJMoa1110352

In patients with ovarian cancer and thrombocytosis, tumors may express interleukin-6, which stimulates production of thrombopoietin. The increase in platelets is associated with more rapid disease progression. Therapies that lower platelet counts may enhance antitumor effects of other agents. Platelets are highly reactive cellular effectors of hemostasis, immunity, and inflammation. 1 The concept that platelets play key roles in cancer growth and metastasis is long-standing. In fact, the clinical observation that thrombocytosis (defined as a platelet count of >450,000 per cubic millimeter) occurs in patients with solid tumors was made more than 100 years ago. 2 , 3 Nearly 40% of persons incidentally found to have platelet counts exceeding 400,000 per cubic millimeter in the absence of iron deficiency and benign inflammatory conditions have an occult cancer, most commonly a primary gastrointestinal, lung, breast, or ovarian cancer. 4 Beyond clinical observations, experimental evidence . . .