CLINICAL SIGNIFICANCE OF HEMOSTASIS SCREENING TESTS IN MULTIPLE MYELOMA

Gülden Sincan¹, Fuat Erdem¹, Adil Furkan Kiliç²

¹Department of Hematology, Medical School, Atatürk University, Erzurum, Turkey - ²Department of Internal Medicine, TC Ministry of Health Malazgirt State Hospital, Muş, Turkey

Introduction: In multiple myeloma cases, the tendency to both bleeding and thrombosis increases as a result of disruption of the hemostatic balance. We aimed to investigate the hemostasis parameters and their clinical importance, the relationship of hemostasis parameters with other prognostic factors in patients with multiple myeloma.  

Materials and methods: In our study, the files of 150 MM patients were retrospectively analyzed. Age, gender, hemogram and biochemistry parameters, hemostasis parameters, beta 2 microglobulin, immunoglobulin levels, disease type and stage were recorded. Thirty healthy cases were examined as the control group. Statistical evaluations were made by the SPSS 20 program. 

Results: The platelet value in female cases was significantly lower than in male cases (p=0.005). A significant association was found between the stage of the disease and the platelet value (p=0.02). A positive correlation was determined between prothrombin time and lactate dehydrogenase value (p=0.01, r=0.196). There was a negative correlation between activated partial thromboplastin time and albumin, thrombocyte levels, and a positive correlation with D Dimer (p=0.02 r=-0.34, p=0.01 r=-0.37, p=0.01 r=0.38, respectively). In the control group, prothrombin time, activated partial thromboplastin time, international normalized ratio, D Dimer values were significantly lower (p=0.002, p=0.48, p=0.007, p<0.001), and fibrinogen and thrombocyte values were significantly higher (p=0.003, p<0.001) compared to the multiple myeloma group. No correlation was found between hemostasis parameters and bleeding, thrombotic events.

Conclusion: Hemostasis tests of patients with multiple myeloma are defective. Negative effects of female gender, advanced disease, elevated lactate dehydrogenase, and low albumin values on hemostasis parameters were determined.