多发性骨髓瘤合并静脉血栓栓塞症的研究进展

Research progress on multiple myeloma complicated with venous thromboembolism

多发性骨髓瘤(MM)为浆细胞异常增生的恶性肿瘤,是发生静脉血栓栓塞症(VTE)的高风险血液系统肿瘤之一。凝血纤溶系统紊乱、炎症因子分泌增多、血小板过度激活、内皮细胞损伤等多种机制参与MM高凝状态的形成。免疫调节药物的应用进一步增加了MM患者VTE的发生率。国际骨髓瘤工作组(IMWG)提出的血栓风险分层因预测能力低、预防效果欠佳而备受争议。本文结合国内外相关研究对MM合并VTE的发生机制及预防进展做一综述。

Multiple myeloma(MM)is a malignant tumor with abnormal proliferation of plasma cells,which is one of the hematologic malignancies with high risk of venous thromboembolism(VTE).The disorder of coagulation and fibrinolysis system,increased secretion of inflammatory factors,platelet hyperactivation,injury of endothelial cells and other mechanisms are involved in the formation of MM hypercoagulant state.The use of immunomodulatory drugs further increased the incidence of VTE in MM patients.The recommendations proposed by the International Myeloma Working Group(IMWG)remain controversial due to its poor predictive ability and prevention effect.In this article,the pathogenesis and prevention of MM with VTE are reviewed based on recent research progress in China and abroad.