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Case Reports
. 2024 Aug 8;391(6):570-571.
doi: 10.1056/NEJMc2406453.

Myeloma Therapy for Monoclonal Gammopathy of Thrombotic Significance

Giselle Salmasi  1 , David L Murray  2 , Anand Padmanabhan  2
Affiliations
Case Reports

Myeloma Therapy for Monoclonal Gammopathy of Thrombotic Significance

Giselle Salmasi et al. N Engl J Med. .
No abstract available

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Figures

Figure 1.
Figure 1.
(A) Key clinical events, platelet counts and serotonin release assay (SRA) results over a two year period are shown. (B) HIT ELISA results and M-protien/MGUS level in relation to DVd treatment is presented. Chemiluminescent HIT immunoassay (HemosIL AcuStar HIT-IgG (PF4/H, Werfen) was negative on five different patient samples, reminiscent of vaccine-induced immune thrombotic thrombocytopenia (VITT) antibodies (data not shown). Abbreviations used: IVIg- Intravenous Immunoglobulin G; DVT- deep venous thrombosis; PE- pulmonary embolism; DVd- Daratumumab-bortezomib-dexamethasone; ICH- Intracranial hemorrhage; M protein- MGUS (monoclonal antibody) protein level. Arrows under “DVd” represent first day of each treatment cycle. (C) Displayed are liquid chromatography-electrospray ionization quadrupole time-of-flight mass spectrometry (LC-ESI-QTOF MS) light chain (LC) +11 (m/z) distributions of serum proteins and (D) Anti-PF4 antibodies isolated from the patient’s serum as described in the Supplementary Appendix.
See this image and copyright information in PMC

Comment in

References

    1. Kanack AJ, Schaefer JK, Sridharan M, et al. Monoclonal gammopathy of thrombotic/thrombocytopenic significance. Blood 2023;141:1772–6. - PMC - PubMed
    1. Kanack AJ, Bayas A, George G, et al. Monoclonal and oligoclonal anti-platelet factor 4 antibodies mediate VITT. Blood 2022;140:73–7. - PMC - PubMed
    1. Vayne C, Rollin J, Gruel Y, et al. PF4 Immunoassays in Vaccine-Induced Thrombotic Thrombocytopenia. N Engl J Med 2021;385:376–8. - PMC - PubMed

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