TY - JOUR
T1 - Pathogenesis and management of bleeding and thrombosis in plasma cell dyscrasias
AU - Eby, Charles
PY - 2009/4
Y1 - 2009/4
N2 - Unexpectedly high rates of venous thromboembolic events (VTE) concurrent with the introduction of highly effective immune modulating drugs thalidomide and lenolidomide for treatment of multiple myeloma have focused attention on the incidence and underlying pathophysiology of VTE in patients with plasma cell dyscrasias, and on thromboprophylaxis approaches. While bleeding complications are relatively uncommon in patients with lymphoproliferative disorders, acquired von Willebrand syndrome, typically occurring in patients with monoclonal gammopathy of unknown significance, and acquired coagulopathies associated with primary amyloidosis can present with haemorrhagic complications and both are challenging to manage. This review highlights these important haemostasis-related complications of plasma cell dyscrasias and provides an overview of other uncommon bleeding and thrombotic events that can affect diagnostic and therapeutic management of clonal plasma cell disorders. Due to the infrequency of most of these haemostasis complications, available information is typically based on retrospective cases or series.
AB - Unexpectedly high rates of venous thromboembolic events (VTE) concurrent with the introduction of highly effective immune modulating drugs thalidomide and lenolidomide for treatment of multiple myeloma have focused attention on the incidence and underlying pathophysiology of VTE in patients with plasma cell dyscrasias, and on thromboprophylaxis approaches. While bleeding complications are relatively uncommon in patients with lymphoproliferative disorders, acquired von Willebrand syndrome, typically occurring in patients with monoclonal gammopathy of unknown significance, and acquired coagulopathies associated with primary amyloidosis can present with haemorrhagic complications and both are challenging to manage. This review highlights these important haemostasis-related complications of plasma cell dyscrasias and provides an overview of other uncommon bleeding and thrombotic events that can affect diagnostic and therapeutic management of clonal plasma cell disorders. Due to the infrequency of most of these haemostasis complications, available information is typically based on retrospective cases or series.
KW - Acquired von Willebrand syndrome
KW - Haemorrhage
KW - Myeloma
KW - Plasma cell dyscrasia
KW - Thrombosis
UR - http://www.scopus.com/inward/record.url?scp=63149146167&partnerID=8YFLogxK
U2 - 10.1111/j.1365-2141.2008.07577.x
DO - 10.1111/j.1365-2141.2008.07577.x
M3 - Review article
C2 - 19210509
AN - SCOPUS:63149146167
SN - 0007-1048
VL - 145
SP - 151
EP - 163
JO - British Journal of Haematology
JF - British Journal of Haematology
IS - 2
ER -