Patients With Multiple Myeloma Have a Disbalanced Whole Blood Thrombin Generation Profile

BackgroundMultiple myeloma (MM) is associated with a high prevalence of bleeding and an increased risk of thrombo-embolism. MM patients have reduced platelet- and red blood cell (RBC) numbers in blood, which may indicate that the paradoxical hemostasis profile is a consequence of a disturbed platele...

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Bibliographic Details
Published in:Frontiers in cardiovascular medicine 2022-06, Vol.9, p.919495-919495
Main Authors: Li, Li, Roest, Mark, Sang, Yaqiu, Remijn, Jasper A., Fijnheer, Rob, Smit, Karel, Huskens, Dana, Wan, Jun, de Laat, Bas, Konings, Joke
Format: Article
Language:English
Subjects:
blood cells
Cardiovascular Medicine
multiple myeloma
platelet function
thrombin generation
thrombosis
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Summary:BackgroundMultiple myeloma (MM) is associated with a high prevalence of bleeding and an increased risk of thrombo-embolism. MM patients have reduced platelet- and red blood cell (RBC) numbers in blood, which may indicate that the paradoxical hemostasis profile is a consequence of a disturbed platelet and RBC homeostasis. ObjectivesTo get better insight in the disbalanced hemostasis of MM patients. MethodsWe conducted a case-control study on the whole blood (WB) coagulation profiles of 21 MM patients and 21 controls. We measured thrombin generation (TG) in WB and platelet poor plasma (PPP) of MM patients and controls. ResultsIn WB-TG, we observed that the median time to the thrombin Peak was 52% longer in MM patients than in controls, while the median endogenous thrombin potential until the Peak (ETPp) was 39% higher in MM-patients than in controls. In line with these findings, the levels of platelets, RBCs, white blood cells and agonist induced platelet activation were decreased in MM patients compared to controls. The plasma TG experiments showed no differences between MM-patients and controls. ConclusionPatients with MM have a disturbed blood cell metabolism and a disbalanced WB-TG profile. This disbalance may explain the paradoxically high prevalence of bleeding symptoms in MM patients vs. an increased thrombosis risk. There was no disturbance observed in plasma TG, indicating that blood cells are the major determinants for the disbalanced hemostasis in MM patients.
ISSN:2297-055X
2297-055X
DOI:10.3389/fcvm.2022.919495