Thrombosis is associated with inferior survival in multiple myeloma
Thrombosis is associated with inferior survival in multiple myeloma
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DOI：
10.3324/haematol.2012.064444
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发表时间：
2012-10-01
期刊：
影响因子：
--
通讯作者：
Landgren, Ola
中科院分区：
文献类型：
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作者：
Kristinsson, Sigurdur Y.;Pfeiffer, Ruth M.;Landgren, Ola
多发性骨髓瘤患者静脉血栓栓塞和动脉血栓形成的风险增加。我们在一项以人群为基础的研究中评估了静脉和动脉血栓形成对生存的影响，该研究纳入了1987年至2005年在瑞典诊断的9,399例多发性骨髓瘤患者。我们发现合并静脉血栓栓塞的多发性骨髓瘤患者在1年、5年和10年随访时的死亡率高于未合并静脉血栓栓塞的患者，风险比分别为2.9（95%置信区间（CI） 2.4-3.5）、1.6 （95% CI: 1.5-1.8）和1.6 （95% CI: 1.4-1.7）。多发性骨髓瘤合并动脉血栓形成患者的死亡风险增加，风险比分别为3.4 （95% CI: 3.0-3.8）、2.2 （95% CI: 2.0-2.3）和2.1 （95% CI: 1.9-2.1）。在6个月的里程碑性分析中，早期动脉血栓栓塞与较高的死亡风险相关，而不是静脉血栓栓塞。因此，与先前的小型研究相比，我们发现血栓形成与较差的生存率显著相关。预防多发性骨髓瘤患者血栓形成是治疗多发性骨髓瘤的重要目标。
Patients with multiple myeloma are at an increased risk of venous thromboembolism and arterial thrombosis. We assessed the impact of venous and arterial thrombosis on survival in a population-based study of 9,399 multiple myeloma patients diagnosed in Sweden from 1987 to 2005. We found multiple myeloma patients with venous thromboembolism to have a higher mortality at 1-, 5-, and 10-years of follow up compared with those without, with hazard ratios of 2.9 (95% confidence interval (CI) 2.4-3.5), 1.6 (95% CI: 1.5-1.8), and 1.6 (95% CI: 1.4-1.7), respectively. There was an increase in risk of death among multiple myeloma patients with arterial thrombosis, with hazard ratios of 3.4 (95% CI: 3.0-3.8), 2.2 (95% CI: 2.0-2.3), and 2.1 (95% CI: 1.9-2.1), respectively. In landmark analyses at six months, early arterial but not venous thromboembolism was associated with a higher risk of death. Thus, in contrast to prior smaller studies, we found the development of thrombosis to be associated with significantly poorer survival. The prevention of thrombosis in multiple myeloma is an important goal in the management of these patients.