phenprocoumon and Lung-Neoplasms

We report the case of a 76-year-old man with recurrent thromboses and low-grade chronic disseminated intravascular coagulation despite therapeutic oral anticoagulation with phenprocoumon. Work-up revealed a bronchial carcinoma (NSCCL) with hilar and mediastinal lymph node metastasis. The clinical condition was consistent with Trousseau's syndrome. Based on reports in the literature, the therapy was changed from phenprocoumon to intravenous unfractionated heparin (UFH), which was effective in controlling the thrombotic coagulopathy. For practical reasons, despite lack of established effectiveness in Trousseau's syndrome, therapy was switched to low-molecular-weight heparin (LMWH, nadroparine) in therapeutic dosage of 100 IU/kg body wt. subcutaneously 12 hourly. The patient remained free from further thromboembolic events during the last 6.5 months of his life. This case suggests that LMWH might be a convenient alternative to the established therapy with UFH in Trousseau's syndrome.

Topics: Aged; Anticoagulants; Carcinoma, Non-Small-Cell Lung; Heparin; Heparin, Low-Molecular-Weight; Humans; Injections, Subcutaneous; Lung Neoplasms; Male; Paraneoplastic Syndromes; Phenprocoumon; Recurrence; Thromboembolism

Topics: 4-Hydroxycoumarins; Animals; Blood Coagulation; Factor IX; Lung Neoplasms; Male; Mice; Mice, Inbred C57BL; Neoplasm Metastasis; Neoplasm Transplantation; Neoplasms, Experimental; Phenprocoumon; Transplantation, Isogeneic; Vitamin K Deficiency

The effects of long-term anticoagulation with phenprocoumon on growth of the Lewis lung carcinoma (3LL) were studied. Oral anticoagulation initiated at the day of i.m. transplantation of the 3LL into C57BL mice significantly inhibited primary tumour growth and reduced the number of spontaneous metastases to the lungs. Intermittent anticoagulation was without effect on metastasis formation but still retarded primary growth. There was no influence of anticoagulation on the mean survival time (MST) of tumour-bearing animals. Phenprocoumon appears to improve the results of cyclophosphamide of 5-fluorouracil treatment, but there were no statisticially significant differences. In contrast, bleomycin treatment in combination with adjuvant anticoagulation suggested a possible drug synergy. No significant influence of anticoagulation on the response of the primary tumour to irradiattion was found, though the MST of irradiated and anticoagulated animals was greater than in the solely irradiated controls. The present investigations suggest that coumarin derivatives have some direct tumour-inhibiting capacities, but exert their antimetastatic action via deceleration of the blood clotting mechanism.

Topics: 4-Hydroxycoumarins; Animals; Bleomycin; Cyclophosphamide; Dose-Response Relationship, Drug; Female; Lung Neoplasms; Male; Mice; Mice, Inbred C57BL; Neoplasm Metastasis; Neoplasm Transplantation; Neoplasms, Experimental; Phenprocoumon

The frequency of metastases of malignant diethylnitrosamine-induced hepatomas and haemangioendotheliomas of the liver of female Sprague-Dawley rats (29%) was not influenced by application of acetyl-salicylic acid or phenprocoumon. Likewise the anticoagulants did not alter tumor yields and induction periods.

Topics: Animals; Anticoagulants; Aspirin; Carcinoma, Hepatocellular; Coumarins; Diethylnitrosamine; Female; Hemangioendothelioma; Liver Neoplasms; Lung Neoplasms; Neoplasm Metastasis; Phenprocoumon; Rats