TY - JOUR
T1 - Arterial and venous thrombosis in patients
with monoclonal gammopathy of undetermined significance: incidence and risk
factors in a cohort of 1491 patients.
AU - Za, Tommaso
AU - De Stefano, Valerio
AU - Rossi, Elena
AU - Petrucci, Maria Teresa
AU - Andriani, Alessandro
AU - Annino, Luciana
AU - Cimino, Giuseppe
AU - Caravita, Tommaso
AU - Pisani, Francesco
AU - Ciminello, Angela Maria
AU - Torelli, Fabio
AU - Villivà, Nicoletta
AU - Bongarzoni, Velia
AU - Rago, Angela
AU - Betti, Silvia
AU - Levi, Anna
AU - Felici, Stefano
AU - Gentilini, Fabiana
AU - Calabrese, Elisabetta
AU - Leone, Giuseppe
PY - 2013
Y1 - 2013
N2 - 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 3%) MGUS was diagnosed after a thrombotic event. Follow-up
details for a period of at least 12 months after diagnosis of MGUS were
obtained in 1238 patients who had no recent history of thrombosis
(<2 years) prior to diagnosis, for a total of 7334 years. During the followup,
33 of 1238 patients (2 7%) experienced thrombosis, with an incidence
of 2 5 arterial events and 1 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 92, 95%confidence
interval (CI) 1 42–17 04], and of venous thrombosis in patients with a
serum monoclonal (M)-protein level >16 g/l at diagnosis (HR 3 08, 95%CI
1 01–9 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 >16 g/l.
AB - 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 3%) MGUS was diagnosed after a thrombotic event. Follow-up
details for a period of at least 12 months after diagnosis of MGUS were
obtained in 1238 patients who had no recent history of thrombosis
(<2 years) prior to diagnosis, for a total of 7334 years. During the followup,
33 of 1238 patients (2 7%) experienced thrombosis, with an incidence
of 2 5 arterial events and 1 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 92, 95%confidence
interval (CI) 1 42–17 04], and of venous thrombosis in patients with a
serum monoclonal (M)-protein level >16 g/l at diagnosis (HR 3 08, 95%CI
1 01–9 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 >16 g/l.
KW - MGUS
KW - Thrombosis
KW - MGUS
KW - Thrombosis
UR - http://hdl.handle.net/10807/41816
U2 - 10.1111/bjh.12168
DO - 10.1111/bjh.12168
M3 - Article
SN - 0007-1048
VL - 2013
SP - 673
EP - 679
JO - British Journal of Haematology
JF - British Journal of Haematology
ER -