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Monoclonal gammopathy of undetermined significance and multiple myeloma are associated with an increased incidence of venothromboembolic disease
Article first published online: 28 JUN 2004
Copyright © 2004 American Cancer Society
Volume 101, Issue 3, pages 558–566, 1 August 2004
How to Cite
Srkalovic, G., Cameron, M. G., Rybicki, L., Deitcher, S. R., Kattke-Marchant, K. and Hussein, M. A. (2004), Monoclonal gammopathy of undetermined significance and multiple myeloma are associated with an increased incidence of venothromboembolic disease. Cancer, 101: 558–566. doi: 10.1002/cncr.20405
- Issue published online: 19 JUL 2004
- Article first published online: 28 JUN 2004
- Manuscript Revised: 4 MAY 2004
- Manuscript Accepted: 4 MAY 2004
- Manuscript Received: 31 DEC 2003
- Multiple Myeloma Foundation of America
- Pastore Foundation
- multiple myeloma;
- monoclonal gammopathy of undetermined significance;
- plasma cell dyscrasia
Venous thromboembolic disease (VTD) is a recently recognized complication of thalidomide in combination therapy for patients with multiple myeloma (MM). The authors assessed the frequency of VTD and its risk factors in 612 consecutive patients with plasma cell dyscrasia (PCD) who were evaluated and followed from 1991 to 2001.
In the current study, 404 patients were diagnosed with multiple myeloma (MM), 174 with monoclonal gammopathy of undetermined significance (MGUS), and 34 with other forms (excluding amyloidosis). Univariable correlates of VTD were assessed using Kaplan–Meier analysis and Cox proportional hazards analysis.
The authors identified several univariable correlates of VTD in patients with MGUS, including a family and medical history of VTD, immobility, low serum albumin level, and high leukocyte count. Patients with MGUS with immunoglobulin (Ig) G monoclonal immunoglobulin were found to be less prone to develop VTD. In patients with MM, a family and medical history of VTD and the presence of a hypercoagulable state were factors identified in univariable analysis to be associated with an increased risk of VTD. In patients with MM, for each unit increase in serum albumin, the risk of VTD was lower. The type of the treatment regimen did not appear to correlate with the development of VTD.
In the current study, the risk for thromboembolic diseases among patients with PCD was increased compared with the risk in the general population. Further studies are necessary to define the mechanisms involved. Cancer 2004. © 2004 American Cancer Society.