TY - JOUR
TI - Longer procoagulant phospholipid-dependent clotting time, lower endogenous thrombin potential and higher tissue factor pathway inhibitor concentrations are associated with increased VTE occurrence in patients with newly diagnosed multiple myeloma: results of the prospective ROADMAP-MM-CAT study
AU - Fotiou, D.
AU - Sergentanis, T.N.
AU - Papageorgiou, L.
AU - Stamatelopoulos, K.
AU - Gavriatopoulou, M.
AU - Kastritis, E.
AU - Psaltopoulou, T.
AU - Salta, S.
AU - Van Dreden, P.
AU - Sangare, R.
AU - Larsen, A.K.
AU - Terpos, E.
AU - Elalamy, I.
AU - Dimopoulos, M.A.
AU - Gerotziafas, G.T.
JO - Blood cancer journal
PY - 2018
VL - 8
TODO - 11
SP - null
PB - Nature Publishing Group
SN - null
TODO - 10.1038/s41408-018-0135-y
TODO - acetylsalicylic acid;  antithrombin;  biological marker;  blood clotting factor 5;  blood clotting factor 7a;  immunological antineoplastic agent;  PADGEM protein;  phospholipid;  procoagulant;  proteasome inhibitor;  thrombin;  tinzaparin;  tissue factor pathway inhibitor;  antineoplastic agent;  biological marker;  lipoprotein;  lipoprotein-associated coagulation inhibitor;  thrombin, adult;  aged;  Article;  blood clotting time;  cancer diagnosis;  cell activation;  comparative study;  controlled clinical trial;  controlled study;  deep vein thrombosis;  endothelium cell;  female;  human;  hypercoagulability;  lung embolism;  major clinical study;  male;  multiple myeloma;  observational study;  protein blood level;  risk assessment;  risk factor;  sex ratio;  thrombin time;  thrombosis prevention;  venous thromboembolism;  blood;  blood clotting;  cancer staging;  complication;  metabolism;  middle aged;  multiple myeloma;  odds ratio;  thrombophilia;  venous thromboembolism;  very elderly, Adult;  Aged;  Aged, 80 and over;  Antineoplastic Combined Chemotherapy Protocols;  Biomarkers;  Blood Coagulation;  Female;  Humans;  Lipoproteins;  Male;  Middle Aged;  Multiple Myeloma;  Neoplasm Staging;  Odds Ratio;  Thrombin;  Thrombophilia;  Venous Thromboembolism
TODO - Venous thromboembolism (VTE) is a common complication in newly diagnosed symptomatic multiple myeloma (NDMM) patients. We explored cellular and plasma hypercoagulability in NDMM patients to identify relevant biomarkers that can be used in combination with clinical factors in the development of a risk assessment model (RAM) for VTE. Untreated patients (n = 144) with NDMM were prospectively enrolled, baseline biomarkers prior to anti-myeloma treatment and thromboprophylaxis initiation were obtained. These were compared against values in a group of healthy individuals with similar age and sex distribution. The primary study end point was symptomatic VTE occurrence. At 12-month follow-up cumulative VTE rate was 10.4%. NDMM patients showed biological signs of cellular and plasma hypercoagulability and endothelial cell activation. Procoagulant phospholipid clotting time (Procoagulant-PPL) was shorter, P-selectin levels lower and thrombin generation attenuated overall compared to healthy subjects. Longer Procoag-PPL ® , lower endogenous thrombin potential (ETP), and higher levels of tissue factor pathway inhibitor (TFPI) were associated with VTE occurrence. Multivariate analysis showed that Procoag-PPL ® and ETP were independent risk factors for VTE. We conclude that Procoag-PPL ® and ETP can be prospectively incorporated into a RAM for VTE in MM in combination with clinical and disease risk factors. © 2018, The Author(s).
ER -