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Determination of the Procoagulant Activity of Extracellular Vesicle (EV) Using EV-Activated Clotting Time (EV-ACT)
Published on: August 4, 2023
Bleeding and thrombosis risks in plasma cell dyscrasias.
1Washington University School of Medicine, 660 S. Euclid Ave., Box 8118, St Louis MO 63110, USA. eby@labmed.wustl.edu
Hematology. American Society of Hematology. Education Program
|November 21, 2007
Summary
Patients with plasma cell dyscrasias rarely have major bleeding, but serious bleeding and clotting risks exist. Acquired von Willebrand deficiency and amyloidosis cause bleeding, while certain treatments increase venous thromboembolic events (VTE).
Area of Science:
- Hematology
- Oncology
- Internal Medicine
Background:
- Plasma cell dyscrasias (PCD) are associated with hemostasis abnormalities, yet major bleeding is infrequent.
- Acquired von Willebrand deficiency and light-chain (AL) amyloidosis can cause significant hemorrhagic complications in PCD.
- Patients with monoclonal gammopathy of undetermined significance and multiple myeloma have an increased risk of venous thromboembolic events (VTE).
Purpose of the Study:
- To review the hemostatic challenges in plasma cell dyscrasias.
- To discuss the interplay between malignant plasma cells, inflammation, hemostasis, and thrombotic complications.
- To highlight the need for further research into VTE prophylaxis in PCD.
Main Methods:
- Literature review of hemostasis and thrombosis in plasma cell dyscrasias.
- Analysis of bleeding and thrombotic risks associated with PCD and its treatments.
- Discussion of current understanding and gaps in knowledge regarding VTE in PCD.
Main Results:
- While screening hemostasis tests are often abnormal in PCD, major spontaneous bleeding is uncommon.
- Acquired von Willebrand deficiency and AL amyloidosis are significant causes of bleeding in PCD.
- Certain treatments like thalidomide and lenalidomide increase VTE risk in specific multiple myeloma subsets.
Conclusions:
- The complex interactions leading to thrombotic complications in PCD are not fully understood.
- Prospective, randomized trials are essential for guiding optimal VTE prophylaxis strategies in patients with PCD.
- Further research is needed to manage both bleeding and thrombotic risks effectively in PCD patients.
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