title: Thromboelastography, thrombin generation test and thrombodynamics reveal hypercoagulability in patients with multiple myeloma.
abstract: Patients with multiple myeloma (MM) are at increased risk of venous thromboembolism. Therefore, adequate laboratory control of hemostasis and subsequent adjustments of anticoagulant therapy are necessary. We studied hemostasis changes using thromboelastography (TEG), thrombin generation test (TGT) and thrombodynamics (TD) in primary MM patients (PMMpt, n=25) and patients in remission (RMMpt, n=34) during blood stem cell (BSC) mobilization. TD and TEG reveal hypercoagulability in PMMpt (*p<0.05) in relation to healthy volunteers. There was no difference in any of the tests between PMMpt and RMMpt. We detected no heparin effect in 22% of patients one day after the onset of the prophylactic heparin treatment (500 IU/h) during BSC mobilization; tests shifted toward the hypercoagulability in 75% of patients one day after cyclophosphamide (4 g/m2) chemotherapy. Global hemostasis tests were in good agreement with each other, revealed hypercoagulability and heparin "resistance" in patients with MM and may be useful for therapy individualization.
authors.affiliation: a Federal Scientific Clinical Center of Pediatric Hematology, Oncology and Immunology named after Dmitry Rogachev, Ministry of Health , Moscow , Russia.
authors.forename: Marina A
authors.initials: MA
authors.lastname: Gracheva
authors.affiliation: b National Research Center for Hematology, Ministry of Health , Moscow , Russia.
authors.forename: Evdokiya S
authors.initials: ES
authors.lastname: Urnova
authors.affiliation: b National Research Center for Hematology, Ministry of Health , Moscow , Russia.
authors.forename: Elena I
authors.initials: EI
authors.lastname: Sinauridze
authors.affiliation: b National Research Center for Hematology, Ministry of Health , Moscow , Russia.
authors.forename: Ivan D
authors.initials: ID
authors.lastname: Tarandovskiy
authors.affiliation: b National Research Center for Hematology, Ministry of Health , Moscow , Russia.
authors.forename: Elena B
authors.initials: EB
authors.lastname: Orel
authors.affiliation: a Federal Scientific Clinical Center of Pediatric Hematology, Oncology and Immunology named after Dmitry Rogachev, Ministry of Health , Moscow , Russia.
authors.forename: Alexander V
authors.initials: AV
authors.lastname: Poletaev
authors.affiliation: b National Research Center for Hematology, Ministry of Health , Moscow , Russia.
authors.forename: Larisa P
authors.initials: LP
authors.lastname: Mendeleeva
authors.affiliation: a Federal Scientific Clinical Center of Pediatric Hematology, Oncology and Immunology named after Dmitry Rogachev, Ministry of Health , Moscow , Russia.|b National Research Center for Hematology, Ministry of Health , Moscow , Russia.|c Center for Theoretical Problems of Physicochemical Pharmacology RAS , Moscow , Russia.|d Research Department, HemaCore LLC , Moscow , Russia.|e Department of Physics , Moscow State University , Moscow , Russia.|f The Faculty of Biological and Medical Physics, Moscow Institute of Physics and Technology , Dolgoprudniy , Russia.
authors.forename: Fazoil I
authors.initials: FI
authors.lastname: Ataullakhanov
authors.affiliation: a Federal Scientific Clinical Center of Pediatric Hematology, Oncology and Immunology named after Dmitry Rogachev, Ministry of Health , Moscow , Russia.|c Center for Theoretical Problems of Physicochemical Pharmacology RAS , Moscow , Russia.
authors.forename: Anna N
authors.initials: AN
authors.lastname: Balandina
mesh_terms: D000328:Adult; D000368:Aged; D000380:Agranulocytosis / Q000175:diagnosis / Q000209:etiology; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use; D001777:Blood Coagulation; D001780:Blood Coagulation Tests; D005260:Female; D006493:Heparin / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D012074:Remission Induction; D013916:Thrombelastography; D013918:Thrombin Time; D019851:Thrombophilia / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology*; D013927:Thrombosis
chemical_list: D000925:Anticoagulants; D006493:Heparin
keywords: Chemotherapy; hypercoagulability; multiple myeloma; thrombin generation test; thrombodynamics; thromboelastography