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Sánchez Prieto I, Gutiérrez Jomarrón I, Martínez Vázquez C, Rodríguez Barquero P, Gili Herreros P, García-Suárez J. Comprehensive evaluation of genetic and acquired thrombophilia markers for an individualized prediction of clinical thrombosis in patients with lymphoma and multiple myeloma. J Thromb Thrombolysis 2024:10.1007/s11239-024-02977-0. [PMID: 38676874 DOI: 10.1007/s11239-024-02977-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/02/2024] [Indexed: 04/29/2024]
Abstract
Patients diagnosed with lymphoma or multiple myeloma are at elevated risk of venous thromboembolism (VTE). Optimum risk stratification and effective thromboprophylaxis can only be achieved through the development of a multiple-specific risk score that successfully captures all aspects of the heterogeneous prothrombotic environment existing in these patients. Our aim was to identify risk factors for thrombosis and suggest an improved tool combining clinical data, thrombo-inflammatory biomarkers and genetic (Thrombo inCode® test) variables for predicting thrombotic risk in patients with lymphoma and multiple myeloma. A prospective longitudinal study was conducted on newly-diagnosed lymphoma and multiple myeloma patients who presented at our institution between February 2020 and January 2021. The study included 47 patients with lymphoma and 16 patients with multiple myeloma. We performed a follow-up of 1 year or until September 2021. The incidence of venous thrombosis and associated risk factors were analysed, including the genetic Thrombo inCode® test. Khorana and ThroLy scores for lymphoma patients and IMPEDE VTE score for myeloma patients were calculated. At a median follow-up of 9.1 months, VTE incidence was 9.5% (6/63), with 4 and 2 patients with lymphoma and myeloma who developed the events, respectively. Univariate analysis showed that the incidence of thrombosis was significantly higher in patients with ECOG ≥ 2 and prior immobility. Median factor VIII levels were significantly higher in patients with thrombosis (with increased values in all of them). Moreover, there was a trend in genetic variant rs5985 (factor XIII) as a protective factor, and a trend to higher thrombotic risk in patients with factor V Leiden, rs2232698 variant (serpinA10), low total protein S activity, elevated D-dimer, aggressive lymphoma and treatment with dexamethasone. The results of our study demonstrate promise for the potential use of widely accessible markers to increase precision in risk prediction for VTE in patients with lymphoma and multiple myeloma, particularly ECOG ≥ 2, immobility and higher factor VIII levels, as well as lymphoma aggressiveness, treatment with dexamethasone and the haemostatic biomarkers D-dimer and total protein S activity. Additionally, genetic variants factor V Leiden, serpinA10 rs2232698 and factor XIII-A Val34Leu warrant further investigation for use in the research setting.
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Affiliation(s)
- Irene Sánchez Prieto
- Hematology Department, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain.
| | - Isabel Gutiérrez Jomarrón
- Hematology Department, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
| | - Celia Martínez Vázquez
- Hematology Department, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
| | - Pedro Rodríguez Barquero
- Hematology Department, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
| | - Paula Gili Herreros
- Hematology Department, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
| | - Julio García-Suárez
- Hematology Department, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
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Sánchez Prieto I, López Rubio M, Arranz E, Ayala R, Callejas Charavía M, Martín Guerrero Y, Gil Fernández JJ, Valenciano Martínez S, Castilla García L, Argüello Marina M, Aspa Cilleruelo JM, Martínez Vázquez C, García Suárez J. Jumping Translocation in a Patient with Acute Leukemia and Fatal Evolution. Case Rep Oncol 2020; 13:1026-1030. [PMID: 33082743 PMCID: PMC7548953 DOI: 10.1159/000508999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 05/27/2020] [Indexed: 11/19/2022] Open
Abstract
Jumping translocations are uncommon cytogenetic abnormalities in which a segment of a donor chromosome, often 1q, is transferred to two or more receptor chromosomes. We describe the case of a 64-year-old man with a history of acute myeloid leukemia associated with myelodysplastic syndrome, who presented with a relapse of the leukemia and, concomitantly, with the appearance of a jumping translocation involving chromosome 1q. The patient had a poor clinical course without the possibility of performing targeted treatment, and he died 5 months after relapse. Jumping translocations are a reflection of chromosomal instability, and they could be related to epigenetic alterations such as pericentromeric chromatin hypomethylation, telomere shortening, or pathogenic variants of the TP53 gene. The existing data suggests a poor clinical outcome, a high risk of disease progression, and an unfavorable prognosis. More molecular studies are required to gain an in-depth understanding of the genetic mechanism underlying these alterations and their clinical significance and to be able to apply an optimal treatment to patients.
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Affiliation(s)
- Irene Sánchez Prieto
- Department of Hematology, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain
- *Irene Sánchez Prieto, Department of Hematology, Hospital Universitario Príncipe de Asturias, Carretera de Alcalá Meco, s/n, ES–28805 Alcalá de Henares (Spain),
| | - Montserrat López Rubio
- Department of Hematology, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain
| | - Eva Arranz
- Cytogenetic Unit, Department of Hematology, Hospital Universitario de La Princesa, Madrid, Spain
| | - Rosa Ayala
- Department of Hematology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Marta Callejas Charavía
- Department of Hematology, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain
| | - Yolanda Martín Guerrero
- Department of Hematology, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain
| | - Juan José Gil Fernández
- Department of Hematology, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain
| | | | - Lucía Castilla García
- Department of Hematology, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain
| | - María Argüello Marina
- Department of Hematology, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain
| | | | - Celia Martínez Vázquez
- Department of Hematology, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain
| | - Julio García Suárez
- Department of Hematology, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain
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