Experimental Study Of Multiple Myeloma Thrombosis-related Factors

PartⅠThe Clinical Significants of Plasma Thrombomodulin, D-Dimer and fibrinogen in Multiple MyelomaObjectiveTo detect the plasma thrombomodulin, D-Dimer and fibrinogen in Multiple Myeloma and to analyze their relationship with morbid state and clinical significants.Methods1. Enzyme-linked immunosorbent assay was used to detect the level of TM with 45 cases of multiple myeloma patients at different stages.2. To detect the plasma level of D-Dimer and fibrinogen with 45 cases of multiple myeloma patients using STA automatic coagulation analyser.ResultsThe level of plasma thrombomodulin in newly diagnosed patients was higer than that in normal control group and in those group reached platform stage ( P<0.01;P<0.05). There were significant differences between relapsed or refractory group and normal control group or those reached platform stage group(P<0.05), but no significant differences between relapsed or refractory group and newly diagnosed patients(P>0.05). Meanwhile, The level of plasma thrombomodulin in the group with thalidomide combination chemotherapy group was higer than that of newly diagnosed patients(P < 0.05). There were no significant differences between bortezomib combination chemotherapy group and newly diagnosed patients or other chemotherapy group(P>0.05).The level of plasma D-Dimer and fibrinogen of MM was higher than that of normal control group(P<0.01;P<0.05). The expression of D-Dimer of relapsed or refractory group was the maximum,which had significant differences to normal control group,newly diagnosed patients and platform stage group(P<0.05). There were no significant differences of fibrinogen level between newly diagnosed patients, platform stage group and relapsed or refractory group(P>0.05). Also,The level of plasma D-Dimer in thalidomide combination chemotherapy group was higer than newly diagnosed patients(P<0.05),but not in fibrinogen.There were no significant differences of D-Dimer and fibrinogen between bortezomib combination chemotherapy group and newly diagnosed patients or other chemotherapy group(P>0.05).ConclusionsThe level of plasma thrombomodulin of MM was higer than that of normal control group, and that was correlated with the status of MM. The level of plasma thrombomodulin can be modified when thalidomide used, so we conclude that it may be an important factor of thrombosis in MM. The level of plasma D-Dimer and fibrinogen of MM was higer than that of normal control group and the level of D-Dimer can be elevated when thalidomide given, which indirectly prompted the increased thrombosis in MM patients. PartⅡExpression of Vascular Cell Adhesion Molecule-1 in bone marrow MNC and MSCs of Patients With Multiple yelomaObjectiveTo observe the expression of vascular cell adhesion molecule-1 (VCAM-1) at mRNA levels of bone marrow mononuclear cell (BM-MNC) and mesenchymal stem cells (MSCs) in patients with multiple myeloma (MM) and to analyze its significant of progression of disease and thrombosis.MethodsThe expressions of VCAM-1 in BM-MNC and MSCs of patients with MM were detected by reverse transcription-polymerase chain reaction (RT-PCR).Results1. The mRNA level of BM-MNC: VCAM-1 was expressed both in normal control group and myeloma group. The expression of VCAM-1 in newly diagnosed patients with MM was higher than those in normal control group and those in patients reached platform stage(P<0.05). The expression of VCAM-1 in patients with relapsed or refractory group was maximum and higer than those in normal control group(P<0.05). There was no significant deviation between relapsed or refractory group and newly diagnosed patients(P>0.05).2. The mRNA level of MSCs: VCAM-1 was expressed both in normal control group and myeloma group. The expression of VCAM-1 in myeloma group was lower than those in normal control group(P<0.05). There was no significant deviation between newly diagnosed patients and those reached platform stage group and relapsed or refractory group(P>0.05).3. The mRNA level of VCAM-1 in MSCs was higher than that of BM-MNC(P <0.05).4. The mRNA level of VCAM-1 in BM-MNC was concord with the level of TM in plasma, and correlated with their morbid state. ConclusionsVCAM-1 was higer expression in MM BM-MNC. The expressions of VCAM-1 were correlated with the status of MM. VCAM-1 not only is a marker for thrombosis, but olso a factor for morbid state and treatment effectiveness.VCAM-1 was expressed in MM MSCs, and the level is lower than normal control group, but higher than that of BM-MNC. VCAM-1 is important for the formation of bone marrow stromal microenvironment and its integrity of the functions, it plays an important role in the disease pathogenesis.