Skip to main content
Log in

Modification of thrombomodulin plasma levels in refractory myeloma patients during treatment with thalidomide and dexamethasone

  • Original Article
  • Published:
Annals of Hematology Aims and scope Submit manuscript

Abstract

Deep venous thrombosis (DVT) has been variably reported in multiple myeloma patients during treatment with thalidomide alone or in combination with chemotherapy or dexamethasone. With the aim of investigating this complication, we performed, on a cohort of 13 relapsed refractory MM patients treated with low-dose thalidomide (100 mg/day) and dexamethasone (20 mg p.o./day for 4 days every 2 weeks), a serial evaluation of different laboratory parameters implicated in DVT. No significant abnormalities in all genetic, serologic, or plasmatic parameters studied were registered, apart from thrombomodulin which showed significant variations between baseline and 1st-month values and 1st- and 3rd-month values. In conclusion, the evidence of significant variations of thrombomodulin values in the 1st month of therapy, which is considered to involve the highest risk of thrombosis, might support a role for thrombomodulin in this complex mechanism.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Cavenagh JD, Oakervee H (2003) Thalidomide in multiple myeloma: current status and future prospects. Br J Haematol 120:18–26

    Article  CAS  PubMed  Google Scholar 

  2. Rajkumar SV, Hayman S, Gertz MA, Dispenzieri A, Lacy MQ, Greipp PR, Geyer S, Iturria N, Fonseca R, Lust JA, Kyle RA, Witzig TE (2002) Combination therapy with thalidomide plus dexamethasone for newly diagnosed myeloma. J Clin Oncol 20:4319–4323

    Article  CAS  PubMed  Google Scholar 

  3. Zangari M, Anaissie E, Barlogie B, Badros A, Desikan R, Gopal AV, Morris C, Toor A, Siegel E, Fink L, Tricot G (2001) Increased risk of deep-vein thrombosis in patients with multiple myeloma receiving thalidomide and chemotherapy. Blood 98:1614–1615

    Article  CAS  PubMed  Google Scholar 

  4. Zangari M, Siegel E, Barlogie B, Anaissie E, SaghafifarF, Fassas A, Morris C, Fink L, Tricot G (2002) Thrombogenic activity of doxorubicin in myeloma patients receiving thalidomide: implication for therapy. Blood 100(4):1168–1171

    Article  CAS  PubMed  Google Scholar 

  5. Falanga A, Donati MB (2001) Pathogenesis of thrombosis in patients with malignancy. Prog Hematol 73:137–144

    CAS  Google Scholar 

  6. Zangari M, Saghafifar F, Anaissie E, Badros A, Desikan R, Fassas A, Mehta P, Morris C, Toor A, Whitfield D, Siegel E, Barlogie B, Fink L, Tricot G (2002) Activated protein C resistance in the absence of factor V Leiden mutation is a common finding in multiple myeloma and is associated with an increased risk of thrombotic complications. Blood Coagul Fibrinolysis 13(13):187–192

    Article  CAS  PubMed  Google Scholar 

  7. Zangari M, Saghafifar F, Mehta P, Barlogie B, Fink L, Tricot G (2003) The blood coagulation mechanism in multiple myeloma. Semin Thromb Hemost 29(3):275–282

    Article  CAS  PubMed  Google Scholar 

  8. Singhal S, Mehta J, Desikan R, Dan Ayers MS, Roberson P, Eddlemon P, Munshi N, Anaissie E, Wilson C, Dhodapkar M, Zeldis J, Barlogie B (1999) Antitumor activity of thalidomide in refractory multiple myeloma. N Engl J Med 341:1565–1571

    Article  CAS  PubMed  Google Scholar 

  9. Camba L, Peccatori J, Pescarollo A, Tresoldi M, Corradini P, Bregni M (2001) Thalidomide and thrombosis in patients with multiple myeloma. Haematologica 86:1108

    CAS  PubMed  Google Scholar 

  10. Osman K, Comenzo R, Rajkumar SV (2001) Deep venous thrombosis and thalidomide therapy for multiple myeloma. N Engl J Med 344(25):1951–1952

    Article  CAS  PubMed  Google Scholar 

  11. Santos AB, Llamas P, Roman A, PrietoE, de Ona R, de Velasco JF, Tomas JF (2003) Evaluation of thrombophilic states in myeloma patients receiving thalidomide: a reasonable doubt. Br J Haematol 122:159–160

    Article  PubMed  Google Scholar 

  12. Kaushal V, Kohli M, Zangari M, Fink L, Metha P (2002) Endothelial dysfunction in antiangiogenesis-associated thrombosis. J Clin Oncol 20(13):3042–3043

    PubMed  Google Scholar 

  13. Esmon CT (1989) The roles of protein C and thrombomodulin in the regulation of blood coagulation. J Biol Chem 2644:4743

    Google Scholar 

  14. Marchant KK, Comp P (2002) Laboratory issue in diagnosing abnormalities of protein C, thrombomodulin and endothelial cell protein C receptor. Arch Pathol Lab Med 126:1337–1348

    PubMed  Google Scholar 

  15. Ishii H, Uchiyama H, Kazama M (1991) Soluble thrombomodulin antigen in conditioned medium is increased by damage of endothelial cells. Thromb Haemost 65:6118–6125

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to A. Corso.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Corso, A., Lorenzi, A., Terulla, V. et al. Modification of thrombomodulin plasma levels in refractory myeloma patients during treatment with thalidomide and dexamethasone. Ann Hematol 83, 588–591 (2004). https://doi.org/10.1007/s00277-004-0891-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00277-004-0891-6

Keywords

Navigation