An Na, Zhang Liang, Gu Lei, Tang Tingting, Zhou Hui, Tian Guoyan
Department of Hematology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China.
Transl Cancer Res. 2023 Mar 31;12(3):616-623. doi: 10.21037/tcr-23-285. Epub 2023 Mar 27.
This study sought to investigate the clinical characteristics and prognosis of thromboembolism in multiple myeloma (MM).
The PubMed, Embase, Web of Science, Wanfang, and China National Knowledge Infrastructure (CNKI) databases were systematically searched to retrieve relevant articles from the establishment of the databases to May 2022. This meta-analysis was performed to investigate the relationship between thromboembolism and overall survival (OS), progression-free survival (PFS), event-free survival (EFS), and mortality in MM patients. The meta-analysis of the included studies was performed using Revman5.3 software after quality evaluation.
A total of 9 studies from 7 articles, which included 38,047 MM patients and 6,412 cases of thromboembolism in the analysis. The levels of β2 microglobulin affected the occurrence of thromboembolism in MM patients [standard mean difference (SMD) =-0.09, 95% confidence interval (CI): -0.18 to -0.01, P=0.02]. Venous thromboembolism (VTE) predicted poorer OS [hazard ratio (HR) = 0.79, 95% CI: 0.64-0.98, P=0.03] and higher early mortality (HR =2.27, 95% CI: 1.26-4.08, P=0.006) in MM. There was no significant difference in PFS/EFS (HR =0.81, 95% CI: 0.64-1.01, P=0.06) between thrombosis/embolism and non-thrombotic embolism. Arterial thrombosis was associated with significantly higher risk of death at 5 years (HR =1.89, 95% CI: 1.33-2.69, P<0.01).
β2 microglobulin levels were associated with VTE in MM. MM patients with VTE were more likely to have poorer prognosis and higher mortality rate than those without VTE. MM patients with arterial thromboembolism had higher 5-year mortality rate than those without arterial thromboembolism.
本研究旨在探讨多发性骨髓瘤（MM）患者血栓栓塞的临床特征及预后。
系统检索PubMed、Embase、Web of Science、万方和中国知网（CNKI）数据库，以获取从数据库建立至2022年5月的相关文章。进行这项荟萃分析以研究MM患者血栓栓塞与总生存期（OS）、无进展生存期（PFS）、无事件生存期（EFS）及死亡率之间的关系。纳入研究经质量评估后，使用Revman5.3软件进行荟萃分析。
共纳入7篇文章中的9项研究，分析中包括38047例MM患者及6412例血栓栓塞病例。β2微球蛋白水平影响MM患者血栓栓塞的发生[标准均数差（SMD）=-0.09，95%置信区间（CI）：-0.18至-0.01，P=0.02]。静脉血栓栓塞（VTE）预示MM患者的OS较差[风险比（HR）=0.79，95%CI：0.64-0.98，P=0.03]，早期死亡率较高（HR=2.27，95%CI：1.26-4.08，P=0.006）。血栓形成/栓塞与非血栓栓塞患者的PFS/EFS无显著差异（HR=0.81，95%CI：0.64-1.01，P=0.06）。动脉血栓形成与5年死亡风险显著升高相关（HR=1.89，95%CI：1.33-2.69，P<0.01）。
β2微球蛋白水平与MM患者的VTE相关。与无VTE的MM患者相比，有VTE的患者预后更差，死亡率更高。有动脉血栓栓塞的MM患者5年死亡率高于无动脉血栓栓塞的患者。
