Investigation of risk factors in patients with multiple myelom with developing thrombosis

Objective: In this study, we aimed to investigate the risk factors in patients who developed thrombosis and were followed up with the diagnosis of Multiple Myeloma (MM) in the Hematology Clinic of Ondokuz Mayıs University Medical Faculty Hospital. Materials and methods: In our study, demographic data, laboratory values and imaging results of patients diagnosed with MM in the Hematology Clinic of Ondokuz Mayıs University Medical Faculty Hospital between 2012 and 2022 were compared, and patients with thrombosis and those without thrombosis were compared. Results: Twenty-two patients with MM who developed thrombosis and 56 control patients who did not develop thrombosis were included in our study. Of the patients diagnosed with MM, 60.26% were male and 39.74% were female. It was determined that 63.63% of the patients who developed venous thromboembolism (VTE) were under 65 years of age, and 36.37% were 65 years and older. It was observed that 71.79% of the patients' paraprotein types were IgG, 21.79% IgA, 5.12% light chain and 1.28% IgM. It was determined that 58.97% (n=46) of the patients were stage I, 19.23% (n=15) were stage II, and 21.79% (n=17) were stage III. 51.28% of the patients had a history of at least one comorbid disease, and the development of VTE was found to be significant in patients with comorbid disease (p=0.008). A history of VTE was seen in the history of 10.26% of the patients, and it was determined that the previous history of VTE was a factor affecting the development of VTE after diagnosis (p<0.001). The mean survival was found to be 86.8910.02 months in the patient group with VTE, while the mean survival was 132.138.52 months in the patient group without VTE (p=0.039). The development of VTE in patients who received immunomodulatory drugs alone (IMiD) was statistically significant compared to the patients who did not receive IMiD (p=0.028). According to the RMC-I (Revised Myeloma Comorbidity Index) score, 50% (n=39) of the patients were fit, 24.36% (n=19) were intermediate fit, and 25.64% (n=20) were fragile. was found to be. Although VTE developed in 12.82% of fit patients and 21.05% of intermediate fit patients, this rate was 65% in the fragile group, and this difference was found to be statistically significant (p<0.001). It was observed that 40.91% of 22 patients who developed VTE after being diagnosed with MM died during follow-up, and 10.71% of 56 patients who did not develop VTE died. Conclusion: Presence of comorbid disease, previous history of VTE, BMI > 25 kg/m2, fragility according to RMC-I score, and taking IMiD alone were found to be risk factors for the development of VTE in patients with MM. Keywords: Multiple Myeloma, thrombosis, risk factors, RMC-I score