THBS1 and neoplasm: In addition to the DNA alkylation mediated by phosphoramide mustard in tumor cells, cyclophosphamide also exerts a double tumor therapy effect through unsaturated aldehyde, acrolein, most likely during thrombospondin-1 (TSP-1) upregulation, an endogenous angiogenesis inhibitor, to further restrict tumor cells proliferation and migration.60 A previous study conducted on smokers has confirmed that acrolein is directly associated with increased CVD risk via the promotion of platelet aggregation and reduction of circulating early and late angiogenic cells (ACs).18