Multiple myeloma with coagulopathy suspected of being due to paraprotein with lupus anticoagulants activity
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- KIKUCHI Taku
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan Department of Hematology, Japanese Red Cross Medical Center, Tokyo, Japan
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- WAKUI Masatoshi
- Department of Laboratory Medicine, Keio University School of Medicine, Tokyo, Japan
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- KATAGIRI Hisako
- Clinical Laboratory, Keio University Hospital, Tokyo, Japan
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- YAMAGUCHI Kentaro
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
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- OSADA Emiri
- Clinical Laboratory, Keio University Hospital, Tokyo, Japan
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- MURATA Mitsuru
- Department of Laboratory Medicine, Keio University School of Medicine, Tokyo, Japan
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- KATAOKA Keisuke
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan Division of Molecular Oncology, National Cancer Center Research Institute, Tokyo, Japan
抄録
<p>We describe the case of a 70-year-old Japanese woman with multiple myeloma with coagulopathy that was suspected of being due to paraprotein with lupus anticoagulants activity. A close examination of the cause of the prolonged aPTT revealed a positive for all endogenous inhibitors and the presence of LAs were suspected, including the results of the mixing test. Partial response was achieved with multiple chemotherapy regimens, but the coagulation abnormalities did not improve. However, EPd therapy reached a deeper response (normalized the FLC ratio and the achievement of deep minimal residual disease level) , and simultaneously, aPTT normalized and inhibitor disappeared. This suggests that a small amount of paraprotein has LA activity. The patient was successfully treated with rivaroxaban for thromboprophylaxis, without thrombotic or bleeding events. Therefore, in patients with multiple myeloma who have a prolonged aPTT, it is important to suspect the presence of LAs, perform a mixing test, and take appropriate prevention against thrombosis, which may lead to improved outcomes.</p>
収録刊行物
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- International Journal of Myeloma
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International Journal of Myeloma 14 (1), 1-4, 2024
一般社団法人 日本骨髄腫学会
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詳細情報 詳細情報について
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- CRID
- 1390862710142178816
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- ISSN
- 21873143
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- 本文言語コード
- en
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- データソース種別
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- JaLC
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- 抄録ライセンスフラグ
- 使用可