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. 2010 Jun 17;115(24):4991-8.
doi: 10.1182/blood-2009-11-252072. Epub 2010 Mar 18.

Arterial and venous thrombosis in monoclonal gammopathy of undetermined significance and multiple myeloma: a population-based study

Sigurdur Y Kristinsson  1 , Ruth M Pfeiffer, Magnus Björkholm, Lynn R Goldin, Sam Schulman, Cecilie Blimark, Ulf-Henrik Mellqvist, Anders Wahlin, Ingemar Turesson, Ola Landgren
Affiliations

Arterial and venous thrombosis in monoclonal gammopathy of undetermined significance and multiple myeloma: a population-based study

Sigurdur Y Kristinsson et al. Blood. .

Erratum in

  • Blood. 2011 Apr 7;117(14):3938

Abstract

Patients with multiple myeloma (MM) have an increased risk of venous thrombosis. Interestingly, excess risk of venous thromboembolism has been observed among patients with monoclonal gammopathy of undetermined significance (MGUS). Using population-based data from Sweden, we assessed the risks of venous and arterial thrombosis in 18,627 MM and 5326 MGUS patients diagnosed from 1958 to 2006, compared with 70,991 and 20,161 matched controls, respectively. At 1, 5, and 10 years after MM diagnosis, there was an increased risk of venous thrombosis: hazard ratios (95% confidence intervals) were 7.5 (6.4-8.9), 4.6 (4.1-5.1), and 4.1 (3.8-4.5), respectively. The corresponding results for arterial thrombosis were 1.9 (1.8-2.1), 1.5 (1.4-1.6), and 1.5 (1.4-1.5). At 1, 5, and 10 years after MGUS diagnosis, hazard ratios were 3.4 (2.5-4.6), 2.1 (1.7-2.5), and 2.1 (1.8-2.4) for venous thrombosis. The corresponding risks for arterial thrombosis were 1.7 (1.5-1.9), 1.3 (1.2-1.4), and 1.3 (1.3-1.4). IgG/IgA (but not IgM) MGUS patients had increased risks for venous and arterial thrombosis. Risks for thrombosis did not vary by M-protein concentration (> 10.0 g/L or < 10.0 g/L) at diagnosis. MGUS patients with (vs without) thrombosis had no excess risk of MM or Waldenström macroglobulinemia. Our findings are of relevance for future studies and for improvement of thrombosis prophylaxis strategies.

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Figures

Figure 1
Figure 1
Cumulative risk of arterial and venous thrombosis in patients with MM and MGUS compared with matched controls.
Figure 2
Figure 2
Hazard curves for arterial and venous thrombosis among MGUS and MM patients compared with matched controls.
See this image and copyright information in PMC

Comment in

  • Threatening clots in MGUS and myeloma.
    Ludwig H, Delforge M. Ludwig H, et al. Blood. 2010 Jun 17;115(24):4975-6. doi: 10.1182/blood-2010-04-276345. Blood. 2010. PMID: 20558621 No abstract available.

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