title: Acquired resistance to activated protein C (aAPCR) in multiple myeloma is a transitory abnormality associated with an increased risk of venous thromboembolism.
abstract: Acquired activated protein C resistance (aAPCR), not associated with factor V Leiden, has been described in cancer patients with an increased risk of venous thromboembolism (VTE). APCR was determined in 1178 myeloma patients using an activated partial thromboplastin time-based resistance assay in the presence of excess of factor V-deficient plasma; polymerase chain reaction amplification of genomic DNA was used to detect factor V Leiden mutation. A total of 109 patients were found to have abnormal APCR and one-third of them were carriers for the mutation. With a median follow-up of 40 months, the presence of aAPCR was associated with a significantly increased risk of thrombosis (P < or = 0.001). APCR was measured again after treatment in 31 patients with abnormal baseline values and had normalised in 30 of them. This study indicates that aAPCR is the most common single transitory baseline coagulation abnormality associated with VTE in myeloma patients.
authors.affiliation: Department of Haematology, San Bortolo Hospital, Vicenza, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Elice
authors.forename: Louis
authors.initials: L
authors.lastname: Fink
authors.forename: Guido
authors.initials: G
authors.lastname: Tricot
authors.forename: Bart
authors.initials: B
authors.lastname: Barlogie
authors.forename: Maurizio
authors.initials: M
authors.lastname: Zangari
mesh_terms: D020016:Activated Protein C Resistance / Q000150:complications* / Q000235:genetics / Q000401:mortality; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005165:Factor V; D005260:Female; D006579:Heterozygote; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications* / Q000235:genetics / Q000401:mortality; D010314:Partial Thromboplastin Time; D012189:Retrospective Studies; D012306:Risk; D015996:Survival Rate; D013997:Time Factors; D020246:Venous Thrombosis / Q000209:etiology* / Q000235:genetics / Q000401:mortality
chemical_list: C095381:factor V Leiden; D005165:Factor V