Hemostatic changes in patients with malignancy

Alterations of hemostasis commonly accompany the progression of malignant d isease and every known component of the hemostatic mechanism may be affecte d by this disease process. Nearly all patients with an active neoplasm will exhibit at least subtle biochemical changes in hemostasis, and a minority of these patients will also develop clinical thrombosis or hemorrhage. In t his paper. we will review intravascular coagulation and fibrinolysis, throm bocytopenia, and thrombocytosis, as well as more rare thrombotic and hemorr hagic events resulting from the direct interactions of neoplasms, or of the ir products, with the individual elements of hemostatic mechanisms. Thrombo tic and hemorrhagic events resulting from the induction of autoimmune or th rombotic microangiopathic syndromes are also discussed. This review focuses on the clinical thrombotic and bleeding syndromes that may occur as a resu lt of this interaction between neoplasia and hemostasis. (C) 2001 The Japan ese Society of Hematology.