warfarin and Lymphoma--Non-Hodgkin

The value of the oral anticoagulant warfarin sodium and fibrinolytic agents is discussed in relation to cancer surgery. A controlled trial of 128 patients showed that in a variety of recurrent cases the addition of warfarin to chemotherapy doubled the 2-year survival rate. The best results were obtained in postmenopausal patients with breast cancer. Warfarin depresses cellular immune responses which might militate against its use for cases undergoing "curative" surgery. Instead, induction of fibrinolysis by streptokinase or Brinase is suggested, because it increases the activity of the cellular immune mechanism. The results to date of an ongoing controlled randomized trial of streptokinase with surgery of tumors of the large bowel are presented, showing that the trends are in favor of streptokinase therapy; however, insufficient time has elapsed to make it, as yet, statistically significant. The action of streptokinase-induced plasmin and Brinase on lymphocytes is described.

Topics: Adenocarcinoma; Administration, Oral; Antineoplastic Agents; Aspergillus; Breast Neoplasms; Colonic Neoplasms; Drug Evaluation; Female; Fibrinolysis; Fibrinolytic Agents; Humans; Immunity, Cellular; Lymphoma, Non-Hodgkin; Male; Neoplasms; Ovarian Neoplasms; Peptide Hydrolases; Rectal Neoplasms; Streptokinase; Warfarin

A 50-year-old woman with systemic lupus erythematosus developed extensive necrotic skin lesions on her chest and abdomen after the discontinuation of warfarin. The presence of antiphospholipid antibodies suggested a diagnosis of antiphospholipid syndrome. Histopathology from a skin lesion demonstrated marked expansion of the dermal microvasculature by intravascular cellular proliferation and focal thrombosis. The intravascular cells stained positive for the endothelial cell markers CD31 and factor VIII-associated antigen confirming reactive angioendotheliomatosis (RAE). This report is the first to identify RAE occurring in the context of the antiphospholipid syndrome. We suggest that intravascular endothelial proliferation, in concert with thrombosis, contributed to the angio-occlusive pathology.

Topics: Antibodies, Antiphospholipid; Anticoagulants; Antiphospholipid Syndrome; Female; Humans; Lymphoma, Non-Hodgkin; Middle Aged; Skin Neoplasms; Thrombosis; Warfarin

Experiments were made to evaluate the potential role played by thrombogenic factors on the hematogenous arrest of circulating tumor cells in mice with demonstrable coagulopathies associated with the presence of a primary tumor, by administration of "therapeutic" doses of anticoagulants. The effects of warfarin, aspirin and heparin administration on the early arrest patterns of 125IdUrd-labelled TA3 carcinoma and Gardner lymphosarcoma cells injected intravenously into tumor-bearing mice were examined. Several hematologic parameters of carcinoma- and lymphosarcoma-bearing animals were measured prior to anticoagulation experiments and the results indicated that mice had coagulopathies similar to those found in cancer patients with disseminated intravascular coagulation syndrome, i.e., thrombocytopenia and elevated fibrinogen levels. Despite the presence of coagulation abnormalities and effective anticoagulation in recipient animals, all three agents were without effect on localization patterns of both tumor types. It was concluded that the proposed involvement of thrombogenesis in metastasis was probably not due to any role played by those clotting factors inhibited by aspirin, warfarin and heparin in early intravascular tumor cell arrest.

Topics: Animals; Anticoagulants; Aspirin; Blood Coagulation; Carcinoma; Heparin; Lymphoma, Non-Hodgkin; Mice; Neoplasm Metastasis; Neoplasm Transplantation; Neoplasms, Experimental; Neoplastic Cells, Circulating; Thromboplastin; Warfarin

Topics: Anticoagulants; Blood Coagulation; Coagulants; Fibrinogen; gamma-Globulins; Heparin; Iodine Isotopes; Lymphoma; Lymphoma, Non-Hodgkin; Neoplasms; Neoplasms, Experimental; Pharmacology; Physiology; Rats; Research; Sodium; Warfarin

Topics: Anticoagulants; Fibrinogen; Fibrinolysis; Heparin; Iodine; Iodine Isotopes; Lymphoma; Lymphoma, Non-Hodgkin; Metabolism; Neoplasms; Neoplasms, Experimental; Pharmacology; Radiometry; Rats; Research; Warfarin

Topics: Blood Coagulation; Coagulants; Fibrinogen; Heparin; Iodine Isotopes; Lymphoma; Lymphoma, Non-Hodgkin; Neoplasms; Neoplasms, Experimental; Pharmacology; Rats; Research; Warfarin