ABSTRACT
Alterations of hemostasis in cancer patients have long been recognized. The problems of altered hemostasis in malignancy remain extremely complex, present major clinical challenges, and many instances of bleeding or thrombosis in these diseases remain unexplained. Changes in hemostasis secondary to malignancy are certainly multifaceted, and the development of clinical bleeding or thrombosis represents a sum total clinical expression of numerous hemostatic alterations. Mucinous adenocarcinomas are the tumors most commonly associated with thrombus formation. In this malignancy, the sialic acid moiety of the secreted mucin has been shown capable of initiating coagulation by the apparent nonenzymatic activation of Factor X. Antitumor therapy is associated with some correction of abnormal hemostasis. Thrombocytopenia is unquestionably the most common cause of bleeding in patients with both solid tumors and hematologic malignancies. Abnormalities of platelet function are commonly found in association with both solid tumors and hematologic malignancies.
