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Evaluation of thrombosis-related biomarkers before and after therapy in patients with multiple myeloma

Shosaku Nomura1, Tomoki Ito1, Hideaki Yoshimura1

  • 1First Department of Internal Medicine, Kansai Medical University, Osaka, Japan.

Journal of Blood Medicine
|February 7, 2018
PubMed
Abstract

Insights

Multiple myeloma (MM) and its treatments can cause thrombosis by increasing blood clotting markers. Monitoring these biomarkers is crucial for managing therapy-related risks in MM patients.

Area of Science:

  • Hematology
  • Oncology
  • Vascular Biology

Background:

  • Thrombosis is a significant complication in multiple myeloma (MM) patients.
  • Both the vascular endothelium and the hemostatic-coagulatory system are implicated in MM-related thrombosis.
  • Newer MM therapies like lenalidomide and bortezomib, while effective, carry an increased risk of therapy-related thrombosis.

Purpose of the Study:

  • To investigate the impact of multiple myeloma and its therapies on coagulation biomarkers.
  • To compare the effects of melphalan-prednisone (Mel-P), bortezomib, and lenalidomide on specific thrombosis-related biomarkers.

Main Methods:

  • Enzyme-linked immunosorbent assays were used to measure five biomarkers: platelet-derived microparticles (PDMP), plasminogen activator inhibitor-1 (PAI-1), high mobility group box protein-1 (HMGB1), endothelial protein C receptor (EPCR), and soluble vascular cell adhesion molecule-1 (sVCAM-1).
  • Plasma concentrations of these biomarkers were assessed in 103 MM patients and 30 healthy controls.
  • The study analyzed biomarker changes following treatment with Mel-P, bortezomib, or lenalidomide.

Main Results:

  • MM patients exhibited higher plasma concentrations of PDMP, PAI-1, HMGB1, EPCR, and sVCAM-1 compared to healthy controls.
  • All investigated therapies (Mel-P, bortezomib, lenalidomide) led to a reduction in these biomarker levels post-treatment.
  • Differential effects on PDMP, HMGB1, and PAI-1 elevations were observed among the therapies in patients with high EPCR levels.

Conclusions:

  • Both multiple myeloma and its treatments contribute to a hypercoagulable state.
  • This induced hypercoagulability elevates the risk of thrombosis, increasing patient morbidity and mortality.
  • Careful consideration of therapy-related thrombosis is essential when selecting treatment regimens for MM patients.
Keywords:
biomarkerbortezomiblenaridomidemultiple myelomathrombosis

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