Use of a new biomarker, fractal dimension (Df), in assessing the thromboembolic risk in cancer patients


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N. A. Davies1,2, N. K. Harrison3, D. Pudney4, S. N. Stanford1,2, G Mills1,2, G.R. Davies2, M. J. Lawrence1,2, K. Hawkins2, R. H. K. Morris5, P. R. Williams6, P. A. Evans1,2
1Haemostasis Biomedical Research Unit, Abertawe Bro Morgannwg University NHS Trust, Swansea, UK, 2School of Medicine, Swansea University, Swansea, UK, 3Department of Respiratory Medicine, Morriston Hospital, Abertawe Bro Morgannwg University NHS Trust, Swansea, UK, 4Department of Oncology, Singleton Hospital, Abertawe Bro Morgannwg University NHS Trust, Swansea, UK, 5School of Applied Sciences, Cardiff Metropolitan University, Cardiff, UK, 6School of Engineering,Swansea University, Swansea, UK

Background

Cancer is well established to be associated with hypercogaulability, and the formation of thrombosis in patients contributes highly to the mortality of these patients. Early detection of those with cancer, and therefore at increased risk of thrombosis, may facilitate early intervention, improving the prognosis of these patients. Current coagulation tests can only be an adjunct to early diagnosis, therapeutic monitoring and screening in these patient groups. A translational programme between the Colleges of Medicine, Engineering, and the NHS has developed a new biomarker, Fractal Dimension (Df), a measure of blood clot structure and stability, and the time taken to clot (gel time). This biomarker has been shown to be superior to conventional coagulation tests in healthy and therapeutically modified blood, and may improve diagnostic potential in those at risk of thrombosis, such as cancer patients.

Method

Patients who are seen at two cancer clinics in the trust will be asked to take part in the study. Blood samples will be taken at clinic following diagnosis, primary intervention (e.g surgery), completion of treatment regimen (chemotherapy/radiotherapy), and 6-months post-treatment. Samples will be subjected to rheology, to determine the Df and gel time, as well as conventional coagulation tests and inflammatory markers.

Results

Data collected will be analysed, in conjunction with patient history, in order to identify those who encounter a thrombosis. Statistical analysis will be carried out in order to identify and differences between cancer patients compared to our healthy index.

Conclusion

It is anticipated that a difference will be observed in the clot structure of patients with cancer, compared to healthy individuals, which may be used in the early diagnosis and therefore intervention of thrombosis, improving prognosis of these patients, and may be used to screen in order to predict recurrence of clots at different stages of cancer therapy.