Prothrombotic coagulation abnormalities in patients with paraprotein-producing B-cell disorders.
OBJECTIVE
An increased incidence of thromboembolic complications has been observed in multiple myeloma (MM), especially when patients are treated with anthracycline-based chemotherapy. In patients with MM, plasma levels of several prothrombotic coagulation factors are increased, and this can contribute to the prothrombotic state of these patients. Recently, an increased thrombosis risk has also been described for other plasma cell disorders (PCDs), such as monoclonal gammopathy of uncertain significance (MGUS) and systemic amyloidosis. The aim of this study was to analyze prothrombotic coagulation disorders in patients with paraprotein-producing B-cell disorders, such as MGUS, systemic amyloidosis, Waldenström's macroglobulinemia, and MM.


METHODS
An increase in factor VIII and von Willebrand factor was observed in patients with MGUS and systemic amyloidosis that was similar to increases seen in patients with untreated MM. The highest levels were observed in patients with systemic amyloidosis.


RESULTS
We observed several coagulation abnormalities in patients with different PCDs.


CONCLUSIONS
These prothrombotic changes in patients with MM, systemic amyloidosis, and Waldenström's macroglobulinemia might be causally related to the observed incidence of venous thromboembolism in these forms of PCDs.
Auwerda
Johannes J A
JJ
Department of Hematology, Erasmus University Medical Center, Rotterdam, The Netherlands. jjauwerda@hotmail.com
Sonneveld
Pieter
P
de Maat
Moniek P M
MP
Leebeek
Frank W G
FW
D000328:Adult; D000368:Aged; D000686:Amyloidosis / Q000097:blood*; D001402:B-Lymphocytes / Q000378:metabolism / Q000473:pathology; D001779:Blood Coagulation Factors / Q000032:analysis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood* / Q000150:complications / Q000473:pathology; D010266:Paraproteins / Q000032:analysis / Q000378:metabolism; D012307:Risk Factors; D013923:Thromboembolism / Q000097:blood* / Q000209:etiology / Q000473:pathology; D020246:Venous Thrombosis / Q000097:blood* / Q000209:etiology / Q000473:pathology; D008258:Waldenstrom Macroglobulinemia / Q000097:blood* / Q000150:complications / Q000473:pathology
D001779:Blood Coagulation Factors; D010266:Paraproteins