Cancer patients have a prothrombotic state because of the ability of cancer cells to activate the coagulation system and to interact with hematopoietic cells, thus tilting the balance between procoagulants and anticoagulants.1 Overexpression of tissue factor (TF), cancer procoagulant—a cysteine protease that activates factor X—and acquired activated protein C resistance,2 are thought to be the main factors for coagulopathy in malignant disorders. Here, CTSB is linked to cancer.