title: Baseline and treatment-related changes in thrombin generation in patients with multiple myeloma.
abstract: The prothrombotic risk in multiple myeloma (MM) could be potentially assessed by thrombin generation (TG) assays. TG was performed using Calibrated Automated Thrombography with 5 and 1 pM tissue factor. We compared baseline TG among 24 MM patients, 19 MGUS, and 50 healthy controls, and assessed change in TG in MM patients during the initial treatment period at 1, 2, and 3 months. MM subjects demonstrated increased FVIII and VWF:Ag levels pretreatment, and a prothrombotic TG phenotype with increased velocity index, reduced lag time and time-to-peak, and increased resistance to thrombomodulin inhibition. There were no significant changes in TG with treatment for the majority of parameters, however, MM subjects exhibited persistent elevation of velocity index throughout treatment. Two subjects developed thrombosis during the study period despite thromboprophylaxis. This study provides information on the optimal conditions for examining TG as a predictor of thrombotic risk in MM patients.
authors.affiliation: a Haematology Division , SA Pathology , Adelaide , SA , Australia.|b School of Medicine, University of Adelaide , Adelaide , SA , Australia.
authors.forename: Ing S
authors.initials: IS
authors.lastname: Tiong
authors.affiliation: a Haematology Division , SA Pathology , Adelaide , SA , Australia.|c School of Pharmacy and Medical Sciences, University of South Australia , Adelaide , SA , Australia.
authors.forename: Susan E
authors.initials: SE
authors.lastname: Rodgers
authors.affiliation: a Haematology Division , SA Pathology , Adelaide , SA , Australia.|b School of Medicine, University of Adelaide , Adelaide , SA , Australia.|d Haematology Department , The Queen Elizabeth Hospital , Adelaide , SA , Australia.
authors.forename: Cindy H S
authors.initials: CH
authors.lastname: Lee
authors.affiliation: a Haematology Division , SA Pathology , Adelaide , SA , Australia.|c School of Pharmacy and Medical Sciences, University of South Australia , Adelaide , SA , Australia.|d Haematology Department , The Queen Elizabeth Hospital , Adelaide , SA , Australia.
authors.forename: Simon J
authors.initials: SJ
authors.lastname: McRae
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D015415:Biomarkers; D001777:Blood Coagulation / Q000187:drug effects; D001779:Blood Coagulation Factors; D001780:Blood Coagulation Tests; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008998:Monoclonal Gammopathy of Undetermined Significance / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy; D009101:Multiple Myeloma / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy; D013917:Thrombin / Q000378:metabolism*; D013997:Time Factors; D054556:Venous Thromboembolism / Q000097:blood / Q000175:diagnosis / Q000209:etiology; D055815:Young Adult
chemical_list: D015415:Biomarkers; D001779:Blood Coagulation Factors; D013917:Thrombin
keywords: Monoclonal gammopathy; hypercoagulability; multiple myeloma; thrombin generation; venous thromboembolism