Abstract
Platelet-leukocyte aggregates (PLAs) are associated with increased thrombosis risk. The influence of PLA formation is especially important for cancer patients, since thrombosis accounts for approximately 10% of cancer-associated deaths. Our objective was to characterize and quantify PLAs in whole blood samples from lung cancer patients compared to healthy volunteers with the intent to analyze PLA formation in the context of lung cancer-associated thrombosis. Consenting lung cancer patients (57) and healthy volunteers (56) were enrolled at the Dana Cancer Center at the University of Toledo Health Science Campus. Peripheral blood samples were analyzed by flow cytometry. Patient medical history was reviewed through electronic medical records. Most importantly, we found lung cancer patients to have higher percentages of platelet-T cell aggregates (PTCAs) than healthy volunteers among both CD4+ T lymphocyte and CD8+ T lymphocyte populations. Our findings demonstrate that characterization of PTCAs may have clinical utility in differentiating lung cancer patients from healthy volunteers and stratifying lung cancer patients by history of thrombosis.
Highlights
Lung cancer is the most common cause of cancer deaths in the United States [1]
Baseline blood cell percentages were obtained via flow cytometry and showed that lung cancer patients and healthy volunteers did not differ in the baseline percentage of CD4+ cells, CD8+ cells, nor platelets in whole blood (Table 1)
Frequency of platelet-T cell aggregates (PTCAs) were increased in lung cancer patients compared to healthy volunteers, both in number and size of aggregates
Summary
Lung cancer patients are 100 times more likely to develop thrombosis than the general population making lung cancer-associated thrombosis a significant health problem [2]. Thrombosis is a leading cause of death in cancer patients, second only to progression of cancer [5] and patients with cancerassociated VTE have a two- to six-fold higher risk of death compared to patients with thrombosis that do not have cancer [6, 7]. Cancer-associated thrombosis is linked to cisplatin [8], thrombocytosis [9, 10] and cancer patients on chemotherapy with a platelet count > 350,000/ μL had a threefold increase in frequency of VTE [11]. ATE more than doubles the risk of death in cancer patients and quadruples risk of death in lung cancer patients [12, 13]
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