Clinical Analysis Of Coagulation Function In 124 Patients With Multiple Myeloma

Background: Multiple myeloma(MM)is a malignant proliferative disease derived from plasma cells.A large number of monoclonal plasma cells in the bone marrow proliferate abnormally,secreting M protein or fragments thereof,and causing damage to related organs or tissues.MM disease itself has a hypercoagulable state,which can cause abnormal blood coagulation,and is easy to be complicated by thromboembolism and hemorrhage.Treatment with MM patients with drugs such as the immunomodulator thalidomide and the proteasome inhibitor bortezomib also affects coagulation function.At present,there are many studies on the high-coagulation state of MM itself at home and abroad,but there are few studies on the relative coagulation function of MM in different disease stages and the influence of chemotherapy drugs on its coagulation function.Therefore,this paper collects clinical data of 124 patients with MM.And coagulation function and other test results,the MM coagulation function was analyzed from three aspects: disease stage,typing,and chemotherapy drugs.Objective: To observe the changes of coagulation function of MM in different stages of the disease and the characteristics of different types of MM coagulation function,and to observe the effect of different chemotherapy regimens on the coagulation function of MM treatment.Methods: The clinical data and coagulation function of 124 patients with multiple myeloma who were hospitalized in our department were collected.According to the different stages of the disease,it was divided into initial treatment group,remission group and progression group;it was divided into IgG group,IgA group and light chain group according to the stage of the disease;it was divided into bortezomib group,thalidomide group and bortezomib combined with thalidomide chemotherapy group according to the chemotherapy regimen used.The coagulation function of MM patients after different disease periods,different types of classification,and different chemotherapy drugs were statistically analyzed.Results: Coagulation function at different stages of multiple myeloma disease.Patients with D-dimer greater than 1 ?g/ml accounted for 36.07% in the initial treatment group,12.00% in the remission group,and 47.37% in the disease progression group,statistical significance(P = 0.0148),and the content of verified D-dimer was correlated with albumin,M protein,and ?2 microglobulin.Compared with different MM classifications.The proportion of APTT greater than 40 s in IgG,IgA,and light chain groups was 25.64%,36.00%,and 17.65%,respectively,and the difference was statistically significant(p=0.0461).D-dimer was higher than 1?g/ml,the proportions in the IgG,IgA,and light chain groups were 26.92%,36.00%,and 64.71%,respectively,and the difference was statistically significant(p=0.0116).Compared with different chemotherapy regimens before and after treatment,albumin increased before and after treatment,and M protein decreased,and the difference was statistically significant.APTT prolonged after bortezomib group chemotherapy(P=0.014),PT shortened after treatment with thalidomide group(P=0.019),FIB increased earlier(P=0.012),bortezomib combined with thalidomide treatment group There was no statistically significant difference in the changes of coagulation function before and after.Conclusion: Multiple myeloma disease itself has a hypercoagulable state.D-dimer is greater than 1 ?g/ml in the remission group,followed by the initial treatment group,the relapse group is the most,and D-dimer and albumin,the M protein and ?2 microglobulin are correlated,indicating that the hypercoagulable state increases as the disease progresses,and the risk of thrombosis increases.Among the different types of MM patients,IgG type and IgA type APTT are longer,which tend to affect the coagulation system,while the light chain type D-dimer level is higher and the risk of thrombosis increases.Patients with multiple myeloma were treated with bortezomib,thalidomide and bortezomib in combination with thalidomide chemotherapy,the disease status was relieved.After treatment with bortezomib,APTT was prolonged and coagulation function was improved.After treatment with thalidomide,FIB increased,PT was shortened,and the patient's hypercoagulable state was aggravated.It is recommended that patients treated with thalidomide should be treated for thromboprophylaxis.When treated with bortezomib thalidomide,the coagulation function of patients is not obvious Change,but the incidence of thrombotic events has been reported to be significantly reduced.