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Thrombelastography Delineates Hypercoagulability in an Immunocompetent Murine Model of Metastatic Pancreatic Cancer

Karen K Lo, Ernest E Moore, Philip M Mehler, Theresa Chin, Fredric Pieracci, Martin D McCarter, Christopher C Silliman and Carlton C Barnett Jr

Introduction: Pancreatic cancer has the highest risk for venous thrombosis of all gastrointestinal malignancies. Although there are recent consensus guidelines for anticoagulation in cancer patients, the implimentation of prophlaxis anticoagulation is still sub optimal. Current diagnostic tests are unreliable in predicting cancer related hypercoagulability, leading to interest in examining the kinetics of clot formation by thrombelastography. We hypothesize that thrombelastography will characterize hypercoagulability in a metastatic murine model of pancreatic adenocarcinoma.
Methods: C57/BL6 mice, age 7-9 weeks, underwent splenic inoculation with 2.5×105 Pan02 murine pancreatic adenocarcinoma cells. At necropsy, (7 weeks) blood was collected with citrate (1:10 ratio) and TEG was obtained on Thrombelastograph® Analyzer. TEG was compared between mice with cancer and control mice. Data were analyzed using non-parametric methods because our n=5.
Results: Mice with cancer were found to have significantly higher Maximum Amplitude (MA) and G than control mice. Median MA was 60.6 (IQR: 59.4-62) mm in control mice compared to 74.2 (IQR 71.2-76) mm in mice with cancer.
Conclusions: Thrombelastography identifies hypercoagulability in an immunocompetent murine metastatic pancreatic cancer model. Further, as thromboelastography can identify abnormalities in blood coagulation, specific patient guided anti-coagulation treatment may be possible.