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Pathogenesis and management of bleeding and thrombosis in plasma cell dyscrasias
Author(s) -
Eby Charles
Publication year - 2009
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.2008.07577.x
Subject(s) - medicine , dyscrasia , plasma cell , multiple myeloma , monoclonal gammopathy of undetermined significance , lymphoproliferative disorders , von willebrand factor , plasma cell dyscrasia , amyloidosis , intensive care medicine , plasma cell myeloma , plasma cell neoplasm , al amyloidosis , thrombosis , immunology , plasmacytoma , monoclonal , lymphoma , platelet , monoclonal antibody , antibody , immunoglobulin light chain
Summary 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.