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Combination of isocitrate dehydrogenase 1 ( IDH 1 ) mutation and podoplanin expression in brain tumors identifies patients at high or low risk of venous thromboembolism
Author(s) -
Mir Seyed Nazari P.,
Riedl J.,
Preusser M.,
Posch F.,
Thaler J.,
Marosi C.,
Birner P.,
Ricken G.,
Hainfellner J. A.,
Pabinger I.,
Ay C.
Publication year - 2018
Publication title -
journal of thrombosis and haemostasis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.947
H-Index - 178
eISSN - 1538-7836
pISSN - 1538-7933
DOI - 10.1111/jth.14129
Subject(s) - podoplanin , idh1 , medicine , isocitrate dehydrogenase , oncology , glioma , mutation , immunohistochemistry , pathology , cancer research , biology , gene , biochemistry , enzyme
Essentials Risk stratification for venous thromboembolism (VTE) in patients with brain tumors is challenging. Patients with IDH1 wildtype and high podoplanin expression have a 6‐month VTE risk of 18.2%. Patients with IDH1 mutation and no podoplanin expression have a 6‐month VTE risk of 0%. IDH1 mutation and podoplanin overexpression in primary brain tumors appear to be exclusive.Summary Background Venous thromboembolism ( VTE ) is a frequent complication in primary brain tumor patients. Independent studies revealed that podoplanin expression in brain tumors is associated with increased VTE risk, whereas the isocitrate dehydrogenase 1 ( IDH 1) mutation is associated with very low VTE risk. Objectives To investigate the interrelation between intratumoral podoplanin expression and IDH 1 mutation, and their mutual impact on VTE development. Patients/Methods In a prospective cohort study, intratumoral IDH 1 R132H mutation and podoplanin were determined in brain tumor specimens (mainly glioma) by immunohistochemistry. The primary endpoint of the study was symptomatic VTE during a 2‐year follow‐up. Results All brain tumors that expressed podoplanin to a medium‐high extent showed also an IDH 1 wild‐type status. A score based on IDH 1 status and podoplanin expression levels allowed prediction of the risk of VTE . Patients with wild‐type IDH 1 brain tumors and high podoplanin expression had a significantly increased VTE risk compared with those with mutant IDH 1 tumors and no podoplanin expression (6‐month risk 18.2% vs. 0%). Conclusions IDH 1 mutation and podoplanin overexpression seem to be exclusive. Although brain tumor patients with IDH 1 mutation are at very low risk of VTE , the risk of VTE in patients with IDH 1 wild‐type tumors is strongly linked to podoplanin expression levels.