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    Poster Networking

    Venous Thromboembolism

    Poster Networking Session

    PB0990 - Changes in thrombin generation parameters in newly diagnosed multiple myeloma patients in response to anti-myeloma therapy

    Monday, June 26, 2023
    18:30 – 19:30 ET
    Room: Exhibition
    Background: Newly diagnosed multiple myeloma (NDMM) patients have increased risk of venous thromboembolism compared to general population, despite generalized use of thromboprophylaxis. Untreated NDMM patients show an enhanced thrombin generation (TG) profile pre-treatment, compared to controls.

    Aims: To characterize changes of TG parameters among NDMM patients in response to anti-myeloma therapy and to evaluate the influence of the treatment response.

    Methods: This observational and multicentric study enrolled NDMM patients before starting any treatment from 6 Spanish centers (December 2018 -December 2022. Blood samples were collected on 3.2% citrate before starting anti-myeloma treatment and then centralized to our laboratory at Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain. Calibrated automated TG was measured at baseline, after cycle 1 and cycle 4 in PPP at 37°C using the ST-Genesia® analyzer (Diagnostica Stago). TG-derived parameters were assessed: lag time, peak height, endogenous thrombin potential (ETP), velocity index (vel.index) and ETP%inh (percentage of ETP inhibition after adding thrombomodulin). Treatment response after cycle 4 was assessed following International Myeloma Working Group criteria. Any patient requiring anticoagulation at therapeutic doses was withdrawn.

    Results: Patient characteristics (n=76) are described in Table 1. After cycle 1, significantly lower vel.index (116 ± 58 vs. 141.1 ± 67.5, p=0.012) and increased ETP%inh (41.9 ± 17.7 vs. 36.6 ± 17.22, p=0.012) were observed (Table 2). After cycle 4, not only decreased vel.index and higher ETP%inh were observed, but also a significant reduction of peak height (226.1 ± 70.4 vs. 248.4 ± 68.6, p=0.001). No differences in the variation of TG parameters between cycle 4 and baseline according to treatment response were found, except significantly decreased peak height in patients with at least VGPR.

    Conclusion(s): A decrease in their TG-mediated hypercoagulability has been observed in NDMM patients in response to antimyeloma therapy. Reaching at least VGPR after cycle 4 was associated with a significant reduction in peak height.