title: Risk factors for venous thromboembolism in immunoglobulin light chain amyloidosis.
abstract: Patients with immunoglobulin light chain amyloidosis are at risk for both thrombotic and bleeding complications. While the hemostatic defects have been extensively studied, less is known about thrombotic complications in this disease. This retrospective study examined the frequency of venous thromboembolism in 929 patients with immunoglobulin light chain amyloidosis presenting to a single referral center, correlated risk of venous thromboembolism with clinical and laboratory factors, and examined complications of anticoagulation in this population. Sixty-five patients (7%) were documented as having at least one venous thromboembolic event. Eighty percent of these patients had events within one year prior to or following diagnosis. Lower serum albumin was associated with increased risk of VTE, with a hazard ratio of 4.30 (CI 1.60-11.55; P=0.0038) for serum albumin less than 3 g/dL compared to serum albumin greater than 4 g/dL. Severe bleeding complications were observed in 5 out of 57 patients with venous thromboembolism undergoing treatment with anticoagulation. Prospective investigation should be undertaken to better risk stratify these patients and to determine the optimal strategies for prophylaxis against and management of venous thromboembolism.
authors.affiliation: Departments of Hematology/Oncology, Boston University School of Medicine, MA, USA Amyloidosis Center, Boston University School of Medicine, MA, USA.
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Bever
authors.affiliation: Medicine, Boston University School of Medicine, MA, USA.
authors.forename: Luke I
authors.initials: LI
authors.lastname: Masha
authors.affiliation: Department of Biostatistics, Boston University School of Public Health, MA, USA.
authors.forename: Fangui
authors.initials: F
authors.lastname: Sun
authors.affiliation: Nephrology, Boston University School of Medicine, MA, USA Amyloidosis Center, Boston University School of Medicine, MA, USA.
authors.forename: Lauren
authors.initials: L
authors.lastname: Stern
authors.affiliation: Nephrology, Boston University School of Medicine, MA, USA Amyloidosis Center, Boston University School of Medicine, MA, USA.
authors.forename: Andrea
authors.initials: A
authors.lastname: Havasi
authors.affiliation: Pulmonology, Boston University School of Medicine, MA, USA Amyloidosis Center, Boston University School of Medicine, MA, USA.
authors.forename: John L
authors.initials: JL
authors.lastname: Berk
authors.affiliation: Departments of Hematology/Oncology, Boston University School of Medicine, MA, USA Amyloidosis Center, Boston University School of Medicine, MA, USA.
authors.forename: Vaishali
authors.initials: V
authors.lastname: Sanchorawala
authors.affiliation: Departments of Hematology/Oncology, Boston University School of Medicine, MA, USA Amyloidosis Center, Boston University School of Medicine, MA, USA.
authors.forename: David C
authors.initials: DC
authors.lastname: Seldin
authors.affiliation: Departments of Hematology/Oncology, Boston University School of Medicine, MA, USA Amyloidosis Center, Boston University School of Medicine, MA, USA mark.sloan@bmc.org.
authors.forename: J Mark
authors.initials: JM
authors.lastname: Sloan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000686:Amyloidosis / Q000097:blood / Q000150:complications; D005260:Female; D006470:Hemorrhage / Q000097:blood / Q000209:etiology; D006801:Humans; D007147:Immunoglobulin Light Chains / Q000097:blood*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012709:Serum Albumin / Q000378:metabolism*; D054556:Venous Thromboembolism / Q000097:blood / Q000209:etiology
chemical_list: D007147:Immunoglobulin Light Chains; D012709:Serum Albumin