Download PDF
Thromb Haemost 1997; 77(01): 053-056
DOI: 10.1055/s-0038-1655906
Clinical Studies
Schattauer GmbH Stuttgart

Fibrinolytic and Coagulant Responses to Regional Limb Perfusions of Tumor Necrosis Factor, Interferon-γ, and/or Melphalan

Authors

  • Paula Merryman

    The Hematology Section, Clinical Pathology Department, Warren G. Magnuson Clinical Center, Bethesda, MD, USA

  • Susan H Tannenbaum

    The Hematology Section, Clinical Pathology Department, Warren G. Magnuson Clinical Center, Bethesda, MD, USA

  • Harvey R Gralnick

    The Hematology Section, Clinical Pathology Department, Warren G. Magnuson Clinical Center, Bethesda, MD, USA

  • Kelvin Yu

    1   The Surgery Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA

  • W Scott Arnold

    1   The Surgery Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA

  • H Richard Alexander

    1   The Surgery Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA

  • Douglas Fraker

    1   The Surgery Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA

  • McDonald K Horne III

    The Hematology Section, Clinical Pathology Department, Warren G. Magnuson Clinical Center, Bethesda, MD, USA
Further Information

Publication History

Received 11 June 1996

Accepted after resubmisssion 01 October 1996

Publication Date:
11 July 2018 (online)

 PDF Download  Permissions and Reprints

Summary

Regional limb perfusion with antineoplastic agents stresses the local vasculature in a variety of ways. However, by monitoring the perfusates from limbs treated with melphalan alone or with melphalan plus tumor necrosis factor (TNF) and interferon-γ (IFN-γ), we were able to distinguish the effect of the cytokines on the observed coagulant and fibrinolytic responses. We collected samples of effluent from a series of lower extremities that were perfused with the cytokines and/or melphalan as treatment for localized melanoma. Both regimens produced statistically significant evidence of coagulant and fibrinolytic activation. However, limbs receiving cytokines in addition to the melphalan responded with a sharper rise in tissue plasminogen activator (tPA) and plasmin (plasmin-antiplasmin complexes [PAP]) than limbs treated with melphalan alone. Evidence of thrombin formation (prothrombin fragment 1+2 [FI+2], thrombin-antithrombin complexes [TAT]) was also greater when the cytokines were included, although the response was delayed and less consistent than the fibrinolytic activation.