Intro/Aims: Venous thromboembolism (VTE) is a common complication in cancer patients. The role of thrombophilic polymorphisms in cancer related VTE remains poorly explored. Aim 1 of this study was to determine if Factor V Leiden (G1691A), Prothrombin (PT) G20210A or methylenetetrahydrofolate reductase (MTHFR) C677T are associated with the increased occurrence of VTE in adult oncology subjects compared to nononcology subjects. Aim 2 of this study was to determine if cancer patients with the MTHFR C677T polymorphism who are treated with antimetabolite therapy have an increased incidence of VTE compared to cancer patients who are treated with other chemotherapy.Setting/Methods: A descriptive, comparative, retrospective chart analysis was utilized for this study in an outpatient hematology, oncology clinic in Southern Arizona. Enrolled were 100 adult subjects (age 18 - 85) with documented history of VTE (27 subjects with cancer and 73 noncancer). Subjects were evaluated for Factor V Leiden, PT G20210A, and MTHFR C677T prior to the study. Eleven subjects were treated with antimetabolite chemotherapy and 8 subjects were treated with other chemotherapy.Results: The overall polymorphism frequency for Factor V Leiden was 21%, PT G20210A 4%, and MTHFR C677T 50%. Factor V Leiden was found in 11.1% of cancer subjects and 24.7% of noncancer subjects. Prothrombin G20210A was found in 3.7% of cancer subjects and 4.1% of noncancer subjects. MTHFR C677T was present in 25.9% of cancer subjects and 58.9% of noncancer subjects. No statistical significance was observed between subjects treated with an antimetabolite and positive for MTHFR C677T compared with those treated with other types of chemotherapy.Conclusion: Analysis of the data collected in this study demonstrated overall higher rates than the expected frequencies of all polymorphism for both the cancer and noncancer patients with documented VTE. In this small retrospective study, the only significant finding was that the MTHFR C677T polymorphism was more prevalent in the noncancer group.Currently, there are no specific guidelines for VTE prevention in the outpatient oncology setting. Identification of risk factors, including prothrombotic mutations may reduce risk of VTE and provide guidance for prophylactic treatment recommendations in the outpatient setting.

CoordenaÃÃo de AperfeiÃoamento de NÃvel Superior / CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / RESUMO As doenÃas trombÃticas constituem um sÃrio problema de saÃde pÃblica. Diversas desordens hereditÃrias e ambientais, que afetam o sistema fisiolÃgico anticoagulante, estÃo atualmente estabelecidas como fatores de risco para a ocorrÃncia do evento trombÃtico. Dentre os fatores hereditÃrios, as mutaÃÃes G1691A do gene do fator V e G20210A do gene da protrombina sÃo os mais freqÃentes. A associaÃÃo entre estas alteraÃÃes genÃticas e a ocorrÃncia de eventos trombÃticos desencadeou o desenvolvimento de diversas pesquisas. Neste estudo, 189 pacientes portadores de eventos trombÃticos, atendidos no ambulatÃrio de Hematologia do Centro de Hematologia e Hemoterapia do Cearà - HEMOCE/SESA/UFC, foram analisados para a detecÃÃo da presenÃa das mutaÃÃes G1691A do gene do fator V e G20210A do gene da protrombina. O grupo controle consistiu de 349 voluntÃrios. A freqÃÃncia encontrada na populaÃÃo controle foi de 2% (7/349) para a mutaÃÃo do fator V e 1,7% (6/349) para a mutaÃÃo da protrombina, enquanto que nos pacientes trombofÃlicos a freqÃÃncia destas mutaÃÃes foi de 9% (17/189) e 2,1% (4/349), respectivamente. Dentre os fatores hereditÃrios, apenas a mutaÃÃo do fator V foi significante (p<0,001). Considerando os fatores ambientais de risco, o tabaco, idade > 40 anos e sexo feminino apresentaram significÃncia estatÃstica (p<0,001). Os riscos foram estimados em anÃlises pareadas e nÃo pareadas para o fator V de Leiden (4,8; 5,3; 9,8), tabaco (17,6; 14,9; 33,3), idade idade > 40 anos (2) e sexo feminino (3,7 e 4,1). Os fatores de risco para eventos trombÃticos no Cearà foram tabagismo, idade > 40 anos, sexo feminino, e a mutaÃÃo G1691A do fator V.foram associados com o desenvolvimento de trombose no estado do CearÃ. / Thrombotic diseases are a serious problem for public health. Several hereditary and environmental factors, that affect physiological anticoagulant system, have been nowadays well established as risk factors for thrombosis. Among hereditary factor V Leiden and prothrombin G20210A mutation are the most frequents. The association between several modifications on factor V gene and prothrombin gene in the development of thrombotic events has brought about future searches. In this study, 189 patients with thrombosis attended at the Hematology and Hemoterapy Center of Cearà state âHEMOCE/ Brazil, were analyzed to find out the presence of factor V Leiden and prothrombin G20210A mutation The control group was made up 349 healthy volunteers. In this study, the frequency found of factor V Leiden the control population was of 2% (7/349) and in the patients was 9% (17/189) while the frequency found of prothrombin G20210A mutation the control population was of 1,7% (6/349) and in the patients was 2,1% (4/189). Among hereditary factors only factor V Leiden was significant statistic (p<0,001). Among environmental factors studied, tabagism, age > 40 anos and femele were significant statistic (p<0,001). The ODDS RATIO of the risk factors with significant statistic were factor V de Leiden (4,8; 5,3; 9,8), tabaco (17,6; 14,9; 33,3), age > 40 years old (2) and female (3,7 e 4,1). Our results demonstrate that factor V Leiden, tabagism, age > 40 years old and female were associated with development trombosis in CearÃ.