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Hemostatic abnormalities associated with monoclonal gammopathies
F Robert1, M Mignucci, S A McCurdy
1Medical Service, Hematology-Oncology Section, VA Medical Center, San Juan, Puerto Rico.
The American Journal of the Medical Sciences
|December 1, 1993
Summary
Monoclonal gammopathies are linked to various hemostatic defects, but bleeding complications are rare in patients with lymphoplasmacytic disorders. This study highlights diverse coagulation abnormalities, often without significant clinical impact.
Area of Science:
- Hematology
- Oncology
- Clinical Pathology
Background:
- Monoclonal gammopathies are associated with hemostatic defects.
- Previous observations require confirmation and expansion.
Purpose of the Study:
- To prospectively evaluate the association between monoclonal gammopathies and hemostatic defects.
- To assess the incidence of bleeding complications in patients with lymphoplasmacytic disorders.
Main Methods:
- Prospective evaluation of 42 patients with lymphoplasmacytic disorders.
- Assessment of coagulation tests, including thrombin time, fibrin degradation products, platelet aggregation, and bleeding time.
- Evaluation of serum viscosity and its correlation with coagulation parameters.
Main Results:
- Low incidence of bleeding complications despite diverse hemostatic abnormalities.
- Frequent coagulation abnormalities in myeloma patients: prolonged thrombin time (64%), elevated fibrin degradation products (32%), abnormal platelet aggregation (30-55%), and prolonged bleeding time (22%).
- Potential Bernard-Soulier-type defect suggested by platelet response to ristocetin.
- Negative correlation between serum viscosity and platelet aggregation; positive correlation between viscosity and thrombin time in immunoglobulin myeloma.
Conclusions:
- Lymphoplasmacytic disorders exhibit a wide spectrum of coagulation abnormalities.
- These hemostatic defects are typically not associated with significant clinical bleeding complications.