Merav Leiba1, Sarah Malkiel2, Ivan Budnik3, Gabriela Rozic1, Abraham Avigdor1, Adrian Duek1, Arnon Nagler1, Gili Kenet4, Tami Livnat5. 1. Division of Hematology and Bone Marrow Transplantation, Cancer Research Center, The Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. 2. Division of Pediatrics B, Edmond and Lily Safra Children's Hospital, The Chaim Sheba Medical Center, Tel Hashomer, Israel. 3. Department of Pathophysiology, Sechenov First Moscow State Medical University, Moscow, Russia. 4. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; National Hemophilia Center and Institute of Thrombosis and Hemostasis, Sheba Medical Center, Tel Hashomer, Israel. 5. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; National Hemophilia Center and Institute of Thrombosis and Hemostasis, Sheba Medical Center, Tel Hashomer, Israel. Electronic address: tami.livnat@sheba.health.gov.il.
Abstract
BACKGROUND: Multiple myeloma (MM) is characterized by an increased incidence of thromboembolic events, especially when immunomodulatory drugs are used. Currently, our ability to predict these thrombotic events is limited. We hypothesized that global coagulation tests may be predictive of thrombotic events in MM patients. METHODS: Blood samples were taken from 36 MM patients before and during routine treatment. Thrombin generation (TG) tests including endogenous thrombin potential (ETP) and peak height were analyzed. RESULTS: Patients were followed for a median of 2.5years. Those who developed thrombotic events were characterized by significantly higher ETP and peak height values compared to those who did not (P=0.001). In these patients, we identified a gradual increase in TG parameters that preceded the thrombotic event. Anticoagulation therapy was associated with a significant decrease in ETP and peak height values (P<0.001). There was no statistically significant difference in TG parameters between newly diagnosed MM patients and healthy subjects, as well as between MM patients prior to and during chemotherapy. CONCLUSIONS: TG tests might predict thrombotic events in MM patients. Thus, TG tests may be incorporated into decision-making protocols of prophylactic anticoagulant therapy in MM patients.
BACKGROUND:Multiple myeloma (MM) is characterized by an increased incidence of thromboembolic events, especially when immunomodulatory drugs are used. Currently, our ability to predict these thrombotic events is limited. We hypothesized that global coagulation tests may be predictive of thrombotic events in MMpatients. METHODS: Blood samples were taken from 36 MMpatients before and during routine treatment. Thrombin generation (TG) tests including endogenous thrombin potential (ETP) and peak height were analyzed. RESULTS:Patients were followed for a median of 2.5years. Those who developed thrombotic events were characterized by significantly higher ETP and peak height values compared to those who did not (P=0.001). In these patients, we identified a gradual increase in TG parameters that preceded the thrombotic event. Anticoagulation therapy was associated with a significant decrease in ETP and peak height values (P<0.001). There was no statistically significant difference in TG parameters between newly diagnosed MMpatients and healthy subjects, as well as between MMpatients prior to and during chemotherapy. CONCLUSIONS:TG tests might predict thrombotic events in MMpatients. Thus, TG tests may be incorporated into decision-making protocols of prophylactic anticoagulant therapy in MMpatients.
Authors: Li Li; Mark Roest; Yaqiu Sang; Jasper A Remijn; Rob Fijnheer; Karel Smit; Dana Huskens; Jun Wan; Bas de Laat; Joke Konings Journal: Front Cardiovasc Med Date: 2022-06-27