Thromboelastography, thrombin generation test and thrombodynamics reveal hypercoagulability in patients with multiple myeloma

Gracheva, Marina A.; Урнова, Е. С.; Sinauridze, Elena I.; Tarandovskiy, Ivan D.; Орел, Е Б; Poletaev, A. V.; Mendeleeva, Larisa; Ataullakhanov, Fazoil I.; Баландина, А. Н.

doi:10.3109/10428194.2015.1041385

Cited by 52 publications

(38 citation statements)

References 34 publications

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Section: Discussionsupporting

confidence: 93%

“…Our results obtained with TF 5 PM were consistent with those of Tiong et al who found significantly elevated velocity index and shorter TtPeak in 24 patients compared with 48 controls. 14 Another study found no significant differences in TG parameters between 25 patients and 33 healthy subjects 8. With 1 PM TF, no significant difference was found between patients with and controls, which was in agreement with Leiba et al study comparing 13 patients to 14 controls 12.…”

supporting

confidence: 66%

“…Some previous studies have suggested that TG assay may be a predictive marker of a hypercoagulable state in patients with MM and could thus identify individuals at risk of thrombosis …”

Section: Introductionmentioning

confidence: 99%

“…Some previous studies have suggested that TG assay may be a predictive marker of a hypercoagulable state in patients with MM and could thus identify individuals at risk of thrombosis. 8 The aim of this study was to determine the hypercoagulable state in patients with MM at diagnosis, and after the completion of myeloma therapy.…”

mentioning

confidence: 99%

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The hypercoagulable state in multiple myeloma: The contribution of thrombin generation test

Baccouche

Hadhri

Aissi

et al. 2019

Int J Lab Hematology

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Background Multiple myeloma is a hematologic malignancy which confers a high venous thromboembolic risk. This risk is linked to patient‐related factors, disease‐specific mechanisms, and antimyeloma therapy, especially immunomodulatory drugs. Some studies have suggested that the thrombin generation assay may be a predictive marker of thrombosis. This study aimed to assess the hypercoagulable state in patients with multiple myeloma at diagnosis and after myeloma therapy. Methods Thirty‐one patients with multiple myeloma were included in a prospective study and were compared with 31 matched controls with age and gender. Thrombin generation assay was performed in patients at diagnosis prior to treatment initiation and at the end of myeloma therapy, and in controls. Parameters of lag time, peak thrombin concentration, time to peak, endogenous thrombin potential, and velocity index were analyzed. Results Median age of patients at diagnosis was 58 years (11 men and 20 women). Twenty‐three patients (74%) were classified as high vascular risk and received thromboprophylaxis. No thromboembolic events have been reported during follow‐up, except a symptomatic pulmonary embolism in one patient which occurred at diagnosis. At baseline, patients with myeloma had significantly elevated velocity index as compared to controls (178 vs 128 nmol/L/min; P = .013). High‐risk patients showed an elevation of plasma thrombin generation as compared to low‐risk patients (endogenous thrombin potential = 1244 vs 1052 nmol/L/min; P = .043). Myeloma therapy did not significantly change the thrombin generation parameters. Conclusion Thrombin generation appears to be higher in patients with myeloma compared with controls, especially in high‐risk patients, and does not change significantly after treatment completion.

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Section: Discussionsupporting

confidence: 93%

supporting

confidence: 66%

“…Some previous studies have suggested that TG assay may be a predictive marker of a hypercoagulable state in patients with MM and could thus identify individuals at risk of thrombosis …”

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

The hypercoagulable state in multiple myeloma: The contribution of thrombin generation test

Baccouche

Hadhri

Aissi

et al. 2019

Int J Lab Hematology

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“…Some of the clinical and pharmacological results obtained with it are shown in Fig. 7, and more can be found in recent reports and reviews [67,[80][81][82][83][84][85][86].…”

Section: Spatial Coagulation: Possible Applications Beyond Basic Resementioning

confidence: 87%

Hemostasis and thrombosis beyond biochemistry: roles of geometry, flow and diffusion

Panteleev

Dashkevich

Ataullakhanov

2015

Thrombosis Research

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Thrombin generation in newly diagnosed multiple myeloma during the first three cycles of treatment: An observational cohort study

Chalayer

Tardy‐Poncet

Karlin

et al. 2019

Research and Practice in Thrombosis and Haemostasis

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BackgroundMultiple myeloma (MM) is associated with a high risk of thrombosis, particularly during the first months of treatment including immunomodulatory drugs (IMiDs). There is no consensus on prevention of thromboembolic risk in patients with de novo MM, and identification of patients requiring anticoagulant thromboprophylaxis remains challenging. Evaluating coagulability by an in vitro thrombin generation (TG) test might be a way of identifying such patients.ObjectiveTo determine whether TG assessment could reveal an increase in coagulability during the first three chemotherapy cycles.MethodsThis prospective and longitudinal observational study included patients newly diagnosed with MM. TG was determined in platelet‐rich and platelet‐poor plasma using calibrated automated thrombography with a low tissue factor (TF) concentration.ResultsSeventy‐one patients were enrolled, allowing TG analysis during 213 chemotherapy cycles. TG remained unchanged throughout follow‐up irrespective of treatment regimen, but values determined before cycles 2 and 3 were significantly higher in patients receiving iMiDs‐containing regimens. No association was found between TG and its changes and thrombosis occurrence during follow‐up: venous thrombosis in eight patients; no cardiovascular event. A significantly (87%) lower risk of venous thrombosis was observed in patients receiving prophylaxis with a low‐molecular‐weight heparin (LMWH; OR: 0.13 (95% CI: 0.02‐0.76). Neither bortezomib‐ nor dexamethasone‐containing regimens were associated with thrombotic risk. Changes in TG, as studied, were not associated with thrombotic events.ConclusionsThe only factor associated with a reduction in early thrombotic risk was prophylaxis with LMWH. The issue of how to identify patients requiring prophylactic anticoagulation remains unresolved.

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Thromboelastography, thrombin generation test and thrombodynamics reveal hypercoagulability in patients with multiple myeloma

Cited by 52 publications

References 34 publications

The hypercoagulable state in multiple myeloma: The contribution of thrombin generation test

The hypercoagulable state in multiple myeloma: The contribution of thrombin generation test

Hemostasis and thrombosis beyond biochemistry: roles of geometry, flow and diffusion

Thrombin generation in newly diagnosed multiple myeloma during the first three cycles of treatment: An observational cohort study

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