Gracheva Marina A, Urnova Evdokiya S, Sinauridze Elena I, Tarandovskiy Ivan D, Orel Elena B, Poletaev Alexander V, Mendeleeva Larisa P, Ataullakhanov Fazoil I, Balandina Anna N
a Federal Scientific Clinical Center of Pediatric Hematology, Oncology and Immunology named after Dmitry Rogachev, Ministry of Health , Moscow , Russia.
b National Research Center for Hematology, Ministry of Health , Moscow , Russia.
Leuk Lymphoma. 2015;56(12):3418-25. doi: 10.3109/10428194.2015.1041385. Epub 2015 Jun 18.
Patients with multiple myeloma (MM) are at increased risk of venous thromboembolism. Therefore, adequate laboratory control of hemostasis and subsequent adjustments of anticoagulant therapy are necessary. We studied hemostasis changes using thromboelastography (TEG), thrombin generation test (TGT) and thrombodynamics (TD) in primary MM patients (PMMpt, n=25) and patients in remission (RMMpt, n=34) during blood stem cell (BSC) mobilization. TD and TEG reveal hypercoagulability in PMMpt (*p<0.05) in relation to healthy volunteers. There was no difference in any of the tests between PMMpt and RMMpt. We detected no heparin effect in 22% of patients one day after the onset of the prophylactic heparin treatment (500 IU/h) during BSC mobilization; tests shifted toward the hypercoagulability in 75% of patients one day after cyclophosphamide (4 g/m2) chemotherapy. Global hemostasis tests were in good agreement with each other, revealed hypercoagulability and heparin "resistance" in patients with MM and may be useful for therapy individualization.
多发性骨髓瘤（MM）患者发生静脉血栓栓塞的风险增加。因此，有必要通过实验室对止血进行充分监测，并随后调整抗凝治疗。我们在原发性MM患者（PMMpt，n = 25）和缓解期患者（RMMpt，n = 34）进行造血干细胞（BSC）动员期间，使用血栓弹力图（TEG）、凝血酶生成试验（TGT）和血栓动力学（TD）研究了止血变化。与健康志愿者相比，TD和TEG显示PMMpt存在高凝状态（*p<0.05）。PMMpt和RMMpt之间的任何一项检测均无差异。在BSC动员期间预防性肝素治疗（500 IU/h）开始一天后，我们在22%的患者中未检测到肝素效应；在环磷酰胺（4 g/m2）化疗一天后，75%的患者检测结果转向高凝状态。整体止血检测结果相互之间具有良好的一致性，显示MM患者存在高凝状态和肝素“抵抗”，可能有助于个体化治疗。
