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Assessment of rotation thromboelastometry (ROTEM) parameters in patients with multiple myeloma at diagnosis.
Thromb Res. 2014 Apr; 133(4):667-70.TR

Abstract

INTRODUCTION

Patients with multiple myeloma (MM) have an increased risk of thromboembolic events (TEE). Due to the complex nature of the prothrombotic state in MM, no single laboratory test has been designed to identify patients with the highest risk of developing TEE. Hence, this study is intended to assess the feasibility of using global hemostasis test rotation thromboelastometry (ROTEM) in MM patients to identify the presence of changes indicating hypercoagulability.

MATERIALS AND METHODS

The study included 26 patients with MM at the time of diagnosis and 20 healthy volunteers. Clotting time (CT), clot formation time (CFT), alpha angle (α), maximum clot firmness (MCF) and maximum lysis (ML) were among the most important parameters recorded during the NATEM, INTEM, EXTEM, FIBTEM and APTEM tests.

RESULTS

For the NATEM test, CT and CFT readings were markedly lower in MM patients than in controls (524s v. 753s; p=0.0006 and 136s v. 242s; p=0.02 respectively). However, no marked differences concerning these parameters were observed in the INTEM, EXTEM, FIBTEN or APTEM tests. α-angle values were significantly higher for MM samples according to the NATEM, EXTEM, FIBTEM and APTEM tests (64° v. 48.5°, p=0.02; 77° v. 74°, p=0.02; 80° v.69.5°, p=0.00007; 77° v. 74°, p=0.01 respectively). MCF readings were significantly higher in the FIBTEM test (22mm v. 15.5mm, p=0.0003) in MM patients. Also, the NATEM test revealed a trend toward higher MCF values in MM samples (56mm v. 49.5mm, p=0.055). No marked differences were seen in the INTEM, EXTEM and APTEM tests. ML readings were markedly lower (0 % v. 4.5 %, p=0.0008) in MM samples than in controls according to the FIBTEM test. The studied clot lysis parameters did not differ markedly between analyzed groups in other tests. Marked negative correlations were noted between IgG concentration and CT (EXTEM, FIBTEM) and CFT (INTEM), as well as a significant positive correlation between IgG concentration and MCF (INTEM, FIBTEM) and α (INTEM) in MM IgG patients.

CONCLUSIONS

Our results suggest that patients with MM display changes in ROTEM tests at the time of diagnosis that may indicate a prothrombotic state.

Authors+Show Affiliations

Department of Haematology, Copernicus Memorial Hospital, Medical University of Łódź, Poland. Electronic address: jacek.trelinski@umed.lodz.pl.Department of Haematology, Copernicus Memorial Hospital, Medical University of Łódź, Poland.Department of Haematology, Copernicus Memorial Hospital, Medical University of Łódź, Poland.Department of Experimental Haematology, Copernicus Memorial Hospital, Medical University of Łódź, Poland.Department of Haematology, Copernicus Memorial Hospital, Medical University of Łódź, Poland.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24451990

Citation

Treliński, Jacek, et al. "Assessment of Rotation Thromboelastometry (ROTEM) Parameters in Patients With Multiple Myeloma at Diagnosis." Thrombosis Research, vol. 133, no. 4, 2014, pp. 667-70.
Treliński J, Misiewicz M, Robak M, et al. Assessment of rotation thromboelastometry (ROTEM) parameters in patients with multiple myeloma at diagnosis. Thromb Res. 2014;133(4):667-70.
Treliński, J., Misiewicz, M., Robak, M., Smolewski, P., & Chojnowski, K. (2014). Assessment of rotation thromboelastometry (ROTEM) parameters in patients with multiple myeloma at diagnosis. Thrombosis Research, 133(4), 667-70. https://doi.org/10.1016/j.thromres.2014.01.011
Treliński J, et al. Assessment of Rotation Thromboelastometry (ROTEM) Parameters in Patients With Multiple Myeloma at Diagnosis. Thromb Res. 2014;133(4):667-70. PubMed PMID: 24451990.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Assessment of rotation thromboelastometry (ROTEM) parameters in patients with multiple myeloma at diagnosis. AU - Treliński,Jacek, AU - Misiewicz,Małgorzata, AU - Robak,Marta, AU - Smolewski,Piotr, AU - Chojnowski,Krzysztof, Y1 - 2014/01/14/ PY - 2013/11/22/received PY - 2013/12/19/revised PY - 2014/01/06/accepted PY - 2014/1/24/entrez PY - 2014/1/24/pubmed PY - 2015/1/13/medline KW - Multiple myeloma KW - ROTEM KW - Thromboelastometry SP - 667 EP - 70 JF - Thrombosis research JO - Thromb. Res. VL - 133 IS - 4 N2 - INTRODUCTION: Patients with multiple myeloma (MM) have an increased risk of thromboembolic events (TEE). Due to the complex nature of the prothrombotic state in MM, no single laboratory test has been designed to identify patients with the highest risk of developing TEE. Hence, this study is intended to assess the feasibility of using global hemostasis test rotation thromboelastometry (ROTEM) in MM patients to identify the presence of changes indicating hypercoagulability. MATERIALS AND METHODS: The study included 26 patients with MM at the time of diagnosis and 20 healthy volunteers. Clotting time (CT), clot formation time (CFT), alpha angle (α), maximum clot firmness (MCF) and maximum lysis (ML) were among the most important parameters recorded during the NATEM, INTEM, EXTEM, FIBTEM and APTEM tests. RESULTS: For the NATEM test, CT and CFT readings were markedly lower in MM patients than in controls (524s v. 753s; p=0.0006 and 136s v. 242s; p=0.02 respectively). However, no marked differences concerning these parameters were observed in the INTEM, EXTEM, FIBTEN or APTEM tests. α-angle values were significantly higher for MM samples according to the NATEM, EXTEM, FIBTEM and APTEM tests (64° v. 48.5°, p=0.02; 77° v. 74°, p=0.02; 80° v.69.5°, p=0.00007; 77° v. 74°, p=0.01 respectively). MCF readings were significantly higher in the FIBTEM test (22mm v. 15.5mm, p=0.0003) in MM patients. Also, the NATEM test revealed a trend toward higher MCF values in MM samples (56mm v. 49.5mm, p=0.055). No marked differences were seen in the INTEM, EXTEM and APTEM tests. ML readings were markedly lower (0 % v. 4.5 %, p=0.0008) in MM samples than in controls according to the FIBTEM test. The studied clot lysis parameters did not differ markedly between analyzed groups in other tests. Marked negative correlations were noted between IgG concentration and CT (EXTEM, FIBTEM) and CFT (INTEM), as well as a significant positive correlation between IgG concentration and MCF (INTEM, FIBTEM) and α (INTEM) in MM IgG patients. CONCLUSIONS: Our results suggest that patients with MM display changes in ROTEM tests at the time of diagnosis that may indicate a prothrombotic state. SN - 1879-2472 UR - https://www.unboundmedicine.com/medline/citation/24451990/Assessment_of_rotation_thromboelastometry__ROTEM__parameters_in_patients_with_multiple_myeloma_at_diagnosis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0049-3848(14)00035-8 DB - PRIME DP - Unbound Medicine ER -