文章：

更长的促凝磷脂依赖性凝血时间、较低的内源性凝血酶潜力和较高的组织因子途径抑制剂浓度与新诊断的多发性骨髓瘤患者静脉血栓栓塞发生率增加相关：前瞻性ROADMAP-MM-CAT研究结果

Longer procoagulant phospholipid-dependent clotting time, lower endogenous thrombin potential and higher tissue factor pathway inhibitor concentrations are associated with increased VTE occurrence in patients with newly diagnosed multiple myeloma: results of the prospective ROADMAP-MM-CAT study

原文发布日期：2018-11-07

DOI: 10.1038/s41408-018-0135-y

类型: Article

开放获取: 是

英文摘要：

Venous thromboembolism (VTE) is a common complication in newly diagnosed symptomatic multiple myeloma (NDMM) patients. We explored cellular and plasma hypercoagulability in NDMM patients to identify relevant biomarkers that can be used in combination with clinical factors in the development of a risk assessment model (RAM) for VTE. Untreated patients (n = 144) with NDMM were prospectively enrolled, baseline biomarkers prior to anti-myeloma treatment and thromboprophylaxis initiation were obtained. These were compared against values in a group of healthy individuals with similar age and sex distribution. The primary study end point was symptomatic VTE occurrence. At 12-month follow-up cumulative VTE rate was 10.4%. NDMM patients showed biological signs of cellular and plasma hypercoagulability and endothelial cell activation. Procoagulant phospholipid clotting time (Procoagulant-PPL) was shorter, P-selectin levels lower and thrombin generation attenuated overall compared to healthy subjects. Longer Procoag-PPL®, lower endogenous thrombin potential (ETP), and higher levels of tissue factor pathway inhibitor (TFPI) were associated with VTE occurrence. Multivariate analysis showed that Procoag-PPL® and ETP were independent risk factors for VTE. We conclude that Procoag-PPL® and ETP can be prospectively incorporated into a RAM for VTE in MM in combination with clinical and disease risk factors.

摘要翻译： 

静脉血栓栓塞（VTE）是新诊断症状性多发性骨髓瘤（NDMM）患者的常见并发症。我们探索了NDMM患者的细胞及血浆高凝状态，以确定相关生物标志物，这些标志物可结合临床因素用于VTE风险评估模型（RAM）的开发。研究前瞻性纳入144例未经治疗的NDMM患者，获取其开始抗骨髓瘤治疗和血栓预防前的基线生物标志物数据，并与年龄性别分布相似的健康人群组进行对比。主要研究终点为症状性VTE的发生。12个月随访期间累计VTE发生率为10.4%。NDMM患者表现出细胞及血浆高凝状态以及内皮细胞激活的生物学特征。与健康受试者相比，促凝磷脂凝血时间（Procoagulant-PPL）缩短、P-选择素水平降低、凝血酶生成总体减弱。更长的Procoag-PPL®、较低的内源性凝血酶潜能（ETP）及较高水平组织因子途径抑制物（TFPI）与VTE发生相关。多变量分析显示Procoag-PPL®和ETP是VTE的独立危险因素。我们得出结论：Procoag-PPL®和ETP可联合临床及疾病危险因素，前瞻性纳入多发性骨髓瘤VTE风险评估模型。

原文链接：

Longer procoagulant phospholipid-dependent clotting time, lower endogenous thrombin potential and higher tissue factor pathway inhibitor concentrations are associated with increased VTE occurrence in patients with newly diagnosed multiple myeloma: results of the prospective ROADMAP-MM-CAT study