Paraneoplastic Thrombocytosis in Ovarian Cancer — NEJM

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Study Explains High Platelets in Ovarian Cancer Patients; Survival Reduced 

Highly elevated platelet levels fuel tumor growth and reduce the survival of ovarian cancer patients, an international team of researchers led by scientists at The University of Texas MD Anderson Cancer center reports in the New England Journal of Medicine. 

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NEJM:

wiki:  thrombocytosis ; Paraneoplastic syndrome

Background

The mechanisms of paraneoplastic thrombocytosis in ovarian cancer and the role that platelets play in abetting cancer growth are unclear.

Methods

We analyzed clinical data on 619 patients with epithelial ovarian cancer to test associations between platelet counts and disease outcome. Human samples and mouse models of epithelial ovarian cancer were used to explore the underlying mechanisms of paraneoplastic thrombocytosis. The effects of platelets on tumor growth and angiogenesis were ascertained.

Results

Thrombocytosis was significantly associated with advanced disease and shortened survival.

Plasma levels of thrombopoietin (hormone which regulates the production of platelets by the bone marrow) and interleukin-6 were significantly elevated in patients who had thrombocytosis as compared with those who did not.

Conclusions

These findings support the existence of a paracrine circuit wherein increased production of thrombopoietic cytokines in tumor and host tissue leads to paraneoplastic thrombocytosis, which fuels tumor growth. We speculate that countering paraneoplastic thrombocytosis either directly or indirectly by targeting these cytokines may have therapeutic potential.

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