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Study: Bleeding Risk Underestimated in Patients With Cancer
Vienna, Austria — In a recent study published in Blood, researchers from MedUni Vienna show that haemorrhages are more common in cancer patients than previously thought and are associated with a poor prognosis and an increased risk of death. The results emphasise the need to devote more attention to this serious complication in clinical practice and research in the future.
To gain the new insights, 791 patients with various types of cancer were observed over a period of 19 months. The research team led by Cihan Ay (Department of Medicine I, Division of Haematology and Haemostaseology) in collaboration with Matthias Preusser and Anna Berghoff (Department of Medicine I, Division of Oncology) found a surprisingly high risk of bleeding in cancer patients.
Due to the close interaction between cancer and the blood coagulation system, blood coagulation disorders frequently occur in people with cancer. As tumours can secrete substances that activate coagulation, the risk of thrombosis is increased. However, due to intensive research in recent years, this can now be assessed well and minimised through anticoagulation. In contrast, knowledge about the risk of bleeding in cancer patients is still lacking. "In general, the risk of bleeding in patients with cancer receiving anticoagulation therapy is higher than in the general population. However, very little is known about the risk of bleeding in cancer patients without anticoagulation," says first author Cornelia Englisch (Department of Internal Medicine I, Division of Haematology and Haemostaseology), summarising the starting point of the research work.
Poor prognosis and increased risk of death
As the study shows, haemorrhages in cancer patients not only occur more frequently than previously assumed, but also more frequently in a particularly severe form ("major bleeds"). The risk was also demonstrated in patients who did not receive anticoagulation. In this group, low albumin and haemoglobin levels, two routinely measured laboratory parameters, were associated with an increased risk of bleeding. "We were also able to identify a specific type of haemorrhage that has not previously been considered in clinical research, although it accounts for a significant proportion, almost a third. We called it tumour bleeding because it originates from the tumour itself," Cornelia Englisch reports on an important detail. It was also found that patients with tumours in the head and neck area had a particularly high risk of bleeding.
The study also revealed that bleeding events in patients with cancer are associated with a poor prognosis and an increased risk of death. For the research team, these results emphasise the relevance of bleeding as a serious complication in cancer patients, to which more attention and further research should be devoted to in the future.
Publication: Blood
Bleeding events in patients with cancer: incidence, risk factors, and impact on prognosis in a prospective cohort study.
English C, Moik F, Steiner D, Starzer AM, Berghoff AS, Preusser M, Pabinger I, Ay C.
doi: 10.1182/blood.2024025362
https://pubmed.ncbi.nlm.nih.gov/39190465/
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