Tissue factor-positive microparticles in blood associated with coagulopathy in cancer

Thrombotic events are the major complication in cancer patients, which contribute significantly to the patients’ morbidity and mortality. Upregulation of tissue factor (TF), the primary initiator of blood coagulation, on malignant tumors is associated with hypercoagulability, tumor angiogenesis and progression. Blood-borne TF is mostly present on the surface of circulating microparticles (MPs) and has been described to increase the systemic hypercoagulability in cancer patients. In this issue of Thrombosis and Haemostasis, Hron et al. describe an approximately two-fold increase in TF-positive MPs, that was associated with a four-fold increase in D-dimer level in the blood of Duke’s D colorectal cancer patients compared to tumor-free healthy age- and sex-matched controls. Surprisingly, the increase in TF-positive MPs seen in the circulating blood of these patients was attributed to MPs, which were mainly derived from platelets and – in trend – leukocytes