fondaparinux and Adenocarcinoma

Disseminated intravascular coagulation (DIC) is the physiologic result of pathologic overstimulation of the coagulation system. Despite multiple triggers, a myriad of laboratory abnormalities, and a clinical presentation ranging from gross hemostatic failure to life-threatening thrombosis, or even both simultaneously, a simplified clinical approach augmented by a few readily available tests allows prompt identification of the process and elucidation of treatment opportunities. Platelet counts in DIC may be low, especially in acute sepsis-associated DIC, yet increased in malignancy-associated chronic DIC. Thrombotic risk is not a function of the platelet count, and thrombocytopenia does not protect the patient from thrombosis. The stratification of both thrombotic risk and hemorrhagic risk will be addressed.

Topics: Adenocarcinoma; Aged; Blood Coagulation Factors; Disseminated Intravascular Coagulation; Esophageal Neoplasms; Fatal Outcome; Fondaparinux; Foodborne Diseases; Hemorrhage; Heparin; Hepatitis C, Chronic; Humans; Male; Middle Aged; Multiple Organ Failure; Polysaccharides; Postoperative Complications; Thrombocytopenia; Thrombophlebitis; Thrombosis; Vibrio Infections; Vibrio vulnificus; Young Adult

This in vitro study analyzed the impact of heparins on expression of chemokines in human endometrial adenocarcinoma cell lines.. Cell lines were incubated with unfractionated heparin (UFH), low molecular weight heparins (LMWH) and fondparinux under hypoxic and normoxic conditions. Chemokine (C-X-C motif) ligand 8 (CXCL8), CC-chemokine ligand 2 (CCL2) and CCL5 were detected by enzyme-linked immunosorbent assays and real-time reverse transcriptase-polymerase chain reaction and cell viability by fluorometric assay.. Different adenocarcinoma cell lines had distinct patterns of chemokine expression. UFH attenuated the secretion of CXCL8 and CCL2, and enhanced that of CCL5. The observed effects of heparin were in addition to the anti-coagulatory properties of heparin and dependent on molecular size and charge.. UFH has selective modulating effects on the secretion of CXCL8, CCL2 and CCL5 in different endometrial adenocarcinoma cell lines. Molecular size and charge are relevant for these observed effects. By influencing the expression of these inflammatory mediators and thereby affecting the tumour microenvironment, heparins and related agents might play an essential role in the development of new therapeutic strategies.

Topics: Adenocarcinoma; Cell Line, Tumor; Chemokine CCL2; Chemokine CCL5; Endometrial Neoplasms; Female; Fondaparinux; Gene Expression Regulation, Neoplastic; Heparin; Humans; Hypoxia; Interleukin-8; Polysaccharides

Topics: Adenocarcinoma; Anticoagulants; Benzimidazoles; beta-Alanine; Dabigatran; Drug Resistance; Drug Therapy, Combination; Female; Fondaparinux; Humans; Middle Aged; Neoplasms, Unknown Primary; Polysaccharides; Syndrome; Treatment Outcome; Venous Thrombosis

During the last decade, new anticoagulant drugs with anti-factor-Xa properties have been described (1, 2). Among them is fondaparinux that has been licensed recently. It is a pentasaccharide mimicking the site where heparin binds to antithrombin III (1). This new drug has produced very promising clinical results in the prophylaxis of venous thrombosis after orthopedic surgery (3). Here we report two different clinical situations in which fondaparinux has yielded a successful outcome: first, a patient with repeated cutaneus reaction to several different low molecular weight heparins (LMWH), and second, a patient with severe heparin-induced thrombocytopenia (HIT). We decided to use fondaparinux in both cases since it is commercially available in Spain and mostly because the absence of in vitro cross-reaction with heparins, as discussed later.

Topics: Abortion, Induced; Acute Kidney Injury; Adenocarcinoma; Adult; Aged; Autoimmune Diseases; Combined Modality Therapy; Drug Eruptions; Drug Hypersensitivity; Endometrial Neoplasms; Female; Fibrinolytic Agents; Fondaparinux; Heparin; Heparin, Low-Molecular-Weight; Humans; Lupus Erythematosus, Systemic; Polysaccharides; Postoperative Complications; Pregnancy; Thrombophilia; Thrombosis