title: Thrombosis is associated with inferior survival in multiple myeloma.
abstract: Patients with multiple myeloma are at an increased risk of venous thromboembolism and arterial thrombosis. We assessed the impact of venous and arterial thrombosis on survival in a population-based study of 9,399 multiple myeloma patients diagnosed in Sweden from 1987 to 2005. We found multiple myeloma patients with venous thromboembolism to have a higher mortality at 1-, 5-, and 10-years of follow up compared with those without, with hazard ratios of 2.9 (95% confidence interval (CI) 2.4-3.5), 1.6 (95% CI: 1.5-1.8), and 1.6 (95% CI: 1.4-1.7), respectively. There was an increase in risk of death among multiple myeloma patients with arterial thrombosis, with hazard ratios of 3.4 (95% CI: 3.0-3.8), 2.2 (95% CI: 2.0-2.3), and 2.1 (95% CI: 1.9-2.1), respectively. In landmark analyses at six months, early arterial but not venous thromboembolism was associated with a higher risk of death. Thus, in contrast to prior smaller studies, we found the development of thrombosis to be associated with significantly poorer survival. The prevention of thrombosis in multiple myeloma is an important goal in the management of these patients.
authors.affiliation: Department of Medicine, Division of Hematology, Karolinska University Hospital Solna, SE-171 76 Stockholm, Sweden. sigurdur.kristinsson@karolinska.se
authors.forename: Sigurdur Y
authors.initials: SY
authors.lastname: Kristinsson
authors.forename: Ruth M
authors.initials: RM
authors.lastname: Pfeiffer
authors.forename: Magnus
authors.initials: M
authors.lastname: Björkholm
authors.forename: Sam
authors.initials: S
authors.lastname: Schulman
authors.forename: Ola
authors.initials: O
authors.lastname: Landgren
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D009101:Multiple Myeloma / Q000150:complications* / Q000401:mortality*; D012042:Registries; D013548:Sweden; D013927:Thrombosis / Q000209:etiology*; D054556:Venous Thromboembolism / Q000209:etiology