开发PREVEMM:为新诊断的多发性骨髓瘤患者提供静脉血栓栓塞瘤风险评分
Inés Martínez-Alfonzo1, Diego Velasco-Rodríguez1, Pablo Mínguez-Paniagua2
1Department of Hematology, Hospital Universitario Fundación Jiménez Díaz, IIS-FJD, Madrid, Spain.
Clinical lymphoma, myeloma & leukemia
|November 2, 2025
概括
一个新的PREVEMM评分准确地预测了新诊断的多发性骨髓瘤 (NDMM) 患者在第一年内静脉血栓栓塞 (VTE) 风险. 该工具为个性化的VTE预防策略提供了改进的风险分层.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 血栓形成研究研究
背景情况:
- 静脉血栓栓塞 (VTE) 是新诊断的多发性骨髓瘤 (NDMM) 患者的重要并发症,特别是在第一年内.
- 目前在NDMM中对VTE的风险评估模型缺乏足够的预测准确性.
- 在NDMM中需要改进VTE风险预测工具,以指导预防策略.
研究的目的:
- 开发和验证一种新的风险评分系统,用于预测NDMM患者的第一年VTE.
- 与现有的VTE风险评估工具对比新得分的表现.
主要方法:
- 在2014-2019年间诊断的225名NDMM患者的回顾性分析.
- 使用最小绝对收缩和选择运算符 (LASSO) 正规化开发一个VTE预测模型.
- 使用曲线下的面积 (AUC) 进行性能评估,并与IMPEDE-VTE和SAVED分数进行比较.
主要成果:
- 来自LASSO的PREVEMM得分显示出强大的预测性表现 (AUC:0.86).
- 确定的独立预测因素包括ECOG表现状态,R-ISS阶段,高剂量德克萨米他,升高的LDH,免疫衰竭,脊髓压缩和.
- 在PREVEMM得分显著优于现有的IMPEDE-VTE和SAVED得分 (AUC:0.88对0.61).
结论:
- 在NDMM患者中,PREVEMM得分为VTE提供了优越的风险分层.
- 这种新的评分系统对定制NDMM中血栓预防策略具有潜在的临床实用性.
- 改善VTE预测可以导致更个性化的患者管理和更好的结果.
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