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Thrombin generation as a predictor of thromboembolic events in multiple myeloma patients
Merav Leiba1, Sarah Malkiel2, Ivan Budnik3
1Division 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.
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.
Insights
Thrombin generation tests can predict thrombotic events in multiple myeloma patients. These tests may help guide prophylactic anticoagulant therapy decisions for patients with multiple myeloma.
Area of Science:
- Hematology
- Oncology
- Clinical Coagulation
Background:
- Multiple myeloma (MM) patients exhibit a higher risk of thromboembolic events, particularly with immunomodulatory drug use.
- Current methods for predicting these thrombotic events in MM are insufficient.
- This study investigated the predictive potential of global coagulation tests for thrombotic events in MM.
Purpose of the Study:
- To assess the utility of thrombin generation (TG) tests in predicting thrombotic events in multiple myeloma patients.
- To determine if TG parameters correlate with the occurrence of thromboembolic events.
- To explore the potential role of TG tests in guiding prophylactic anticoagulant therapy.
Main Methods:
- Blood samples were collected from 36 MM patients before and during treatment.
- Thrombin generation (TG) tests, including endogenous thrombin potential (ETP) and peak height, were analyzed.
- Patients were monitored for a median of 2.5 years for thrombotic events.
Main Results:
- Patients who experienced thrombotic events showed significantly higher ETP and peak height values compared to those who did not.
- A gradual increase in TG parameters was observed preceding thrombotic events.
- Anticoagulation therapy led to a significant decrease in ETP and peak height values.
Conclusions:
- Thrombin generation tests show promise in predicting thrombotic events in multiple myeloma patients.
- Incorporating TG tests into clinical practice may aid in the decision-making process for prophylactic anticoagulant therapy.
- Further research could validate TG tests as a predictive tool for thrombotic risk in MM.