Document Detail

Extremely high levels of von Willebrand factor antigen and of procoagulant factor VIII found in multiple myeloma patients are associated with activity status but not with thalidomide treatment.
MedLine Citation:
PMID:  12871448     Owner:  NLM     Status:  MEDLINE    
Venous thromboembolism (VTE) is a major complication in patients with multiple myeloma (MM) during treatment with thalidomide combined with chemotherapy and/or dexamethasone. The pathophysiology is not clear. We performed a cross-sectional study in 20 MM patients who were treated with thalidomide for refractory/relapsed disease. Seven patients (35%) experienced an episode of VTE. Plasma samples were analyzed for known risk factors for VTE and compared with those from 30 MM patients without thalidomide treatment. The patients groups differed in their baseline characteristics in activity status only. Extremely high levels of factor VIII-coagulant activity (FVIII:C, mean 352%) and von Willebrand factor antigen (VWF-Ag, 374%) were found in all patients using thalidomide. All other prothrombotic risk factors were normal. In patients with VTE, VWF-Ag but not FVIII:C, levels were significantly higher as compared with patients without VTE. Patients without thalidomide treatment had significantly lower levels of both coagulation factors but the difference was only due to difference in activity status. High FVIII:C/VWF-Ag levels are found in patients with active MM and this is probably a reflection of increased bone marrow angiogenesis in MM. These prothrombogenic circumstances could contribute to the high incidence of VTE during treatment with thalidomide in combination with dexamethasone/chemotherapy.
M C Minnema; R Fijnheer; P G De Groot; H M Lokhorst
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of thrombosis and haemostasis : JTH     Volume:  1     ISSN:  1538-7933     ISO Abbreviation:  J. Thromb. Haemost.     Publication Date:  2003 Mar 
Date Detail:
Created Date:  2003-07-21     Completed Date:  2003-12-16     Revised Date:  2006-11-07    
Medline Journal Info:
Nlm Unique ID:  101170508     Medline TA:  J Thromb Haemost     Country:  England    
Other Details:
Languages:  eng     Pagination:  445-9     Citation Subset:  IM    
Department of Haematology, University Medical Center Utrecht, Utrecht, The Netherlands.
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MeSH Terms
Antineoplastic Combined Chemotherapy Protocols / adverse effects,  therapeutic use
Cross-Sectional Studies
Factor VIII / analysis*
Middle Aged
Multiple Myeloma / blood*,  complications,  drug therapy
Thalidomide / adverse effects,  therapeutic use*
Thromboembolism / blood,  etiology
Venous Thrombosis / blood,  etiology
von Willebrand Factor / analysis*
Reg. No./Substance:
0/von Willebrand Factor; 50-35-1/Thalidomide; 9001-27-8/Factor VIII
Comment In:
J Thromb Haemost. 2003 Mar;1(3):421-2   [PMID:  12871443 ]
J Thromb Haemost. 2005 May;3(5):1088-9   [PMID:  15869614 ]

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