School of Laboratory Medicine, Sanquan College of Xinxiang Medical University, Xinxiang, People's Republic of China.
Department of Clinical Laboratory, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an. People's Republic of China.
Hematology. 2024 Dec;29(1):2377849. doi: 10.1080/16078454.2024.2377849. Epub 2024 Jul 12.
To explore the changes in the coagulation function of patients newly diagnosed with multiple myeloma (MM) at different stages and with different M protein types, and to analyze the correlation between coagulation indexes and β2-microglobulin (β2-MG).
A total of 371 Patients with newly diagnosed MM (= 371) and healthy controls (= 48) were selected from January 2016 to December 2022. Baseline data, β2-MG and coagulation index values were collected. Indexes included prothrombin time (PT), activated partial thromboplastin time (APPT), fibrinogen (FIB), thrombin time (TT), fibrinogen degradation products (FDP), and D-dimer(D-D). Patients were divided into different groups according to the Durie-Salmon staging system (DS), the International Staging System (ISS) and disease classification (M protein type). The levels of these six indexes were compared among the groups and the correlation between each index and β2-MG was analyzed.
Compared to the normal control group, the levels of PT, FIB, TT, FDP and D-D in the MM group were significantly higher (all < 0.001). As DS and ISS staging increased, the levels of PT, TT, FDP and D-D also increased significantly (all < 0.001). β2-MG was positively correlated with PT, TT, and FDP levels (Spearman = 0.157, 0.270, 0.108, respectively; all < 0.05), and negatively correlated with FIB ( = -0.220, < 0.001). Significant differences existed in the levels of these six indexes among different M protein types (all < 0.001). Among them, PT and APTT increased significantly in the IgA-κ group, FIB increased in the λ light chain group, TT increased in the IgG-κ group, FDP increased in the κ light chain group, and D-D increased in the IgG-λ group.
The degree of coagulation dysfunction in MM patients increases with disease stage and abnormal increases of various coagulation indicators occur in different M protein types and are closely related to β2-MG.
探讨不同分期和不同 M 蛋白类型的初诊多发性骨髓瘤（MM）患者的凝血功能变化，并分析凝血指标与β2-微球蛋白（β2-MG）的相关性。
选取 2016 年 1 月至 2022 年 12 月新诊断 MM 患者（n=371）和健康对照者（n=48），收集患者的基线数据、β2-MG 和凝血指标值。指标包括凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、纤维蛋白原（FIB）、凝血酶时间（TT）、纤维蛋白降解产物（FDP）和 D-二聚体（D-D）。根据 Durie-Salmon 分期系统（DS）、国际分期系统（ISS）和疾病分类（M 蛋白类型）将患者分为不同组，比较各组间 6 项指标水平，并分析各指标与β2-MG 的相关性。
与正常对照组相比，MM 组患者的 PT、FIB、TT、FDP 和 D-D 水平显著升高（均<0.001）。随着 DS 和 ISS 分期的增加，PT、TT、FDP 和 D-D 水平也显著升高（均<0.001）。β2-MG 与 PT、TT 和 FDP 水平呈正相关（Spearman 相关系数分别为 0.157、0.270 和 0.108，均<0.05），与 FIB 水平呈负相关（r=-0.220，<0.001）。不同 M 蛋白类型患者的 6 项指标水平差异均有统计学意义（均<0.001）。其中，IgA-κ 组的 PT 和 APTT 显著升高，λ 轻链组的 FIB 升高，IgG-κ 组的 TT 升高，κ 轻链组的 FDP 升高，IgG-λ 组的 D-D 升高。
MM 患者的凝血功能障碍程度随疾病分期增加而增加，不同 M 蛋白类型的各种凝血指标异常升高，且与β2-MG 密切相关。
