Arterial and venous thrombosis in patients with monoclonal gammopathy of undetermined significance: incidence and risk factors in a cohort of 1491 patients

作者：Za Tommaso; De Stefano Valerio^*; Rossi Elena; Petrucci Maria Teresa; Andriani Alessandro; Annino Luciana; Cimino Giuseppe; Caravita Tommaso; Pisani Francesco; Ciminello Angela; Torelli Fabio; Villiva Nicoletta; Bongarzoni Velia; Rago Angela; Betti Silvia; Levi Anna; Felici Stefano; Gentilini Fabiana; Calabrese Elisabetta; Leone Giuseppe

来源：British Journal of Haematology, 2013, 160(5): 673-679.

DOI：10.1111/bjh.12168

• Arterial thrombosis
• venous thrombosis
• monoclonal gammopathy of undetermined significance

Monoclonal gammopathy of undetermined significance (MGUS) has been associated with an increased risk of thrombosis. We carried out a retrospective multicentre cohort study on 1491 patients with MGUS. In 49 patients (3 center dot 3%) MGUS was diagnosed after a thrombotic event. Follow-up details for a period of at least 12months after diagnosis of MGUS were obtained in 1238 patients who had no recent history of thrombosis (%26lt;2years) prior to diagnosis, for a total of 7334years. During the follow-up, 33 of 1238 patients (2 center dot 7%) experienced thrombosis, with an incidence of 2 center dot 5 arterial events and 1 center dot 9 venous events per 1000 patient-years. Multivariate analysis showed increased risks of arterial thrombosis in patients with cardiovascular risk factors [hazard ratio (HR) 4 center dot 92, 95%confidence interval (CI) 1 center dot 4217 center dot 04], and of venous thrombosis in patients with a serum monoclonal (M)-protein level %26gt;16g/l at diagnosis (HR 3 center dot 08, 95%CI 1 center dot 019 center dot 36). No thrombosis was recorded in patients who developed multiple myeloma (n=50) or other neoplastic diseases (n=21). The incidence of arterial or venous thrombosis in patients with MGUS did not increase relative to that reported in the general population for similarly aged members. Finally, the risk of venous thrombosis did increase when the M-protein concentration exceeded %26gt;16g/l.

• 出版日期2013-3