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Japanese Journal of Clinical Oncology Advance Access originally published online on August 11, 2007
Japanese Journal of Clinical Oncology 2007 37(8):609-614; doi:10.1093/jjco/hym074
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© 2007 Foundation for Promotion of Cancer Research

The Prolonged Activated Partial Thromboplastin Time at Diagnosis Indicates Less Favorable Prognosis in IgA Myeloma

Hao-Wei Teng1, Po-Min Chen1, Ya-Hsu Yang2 and Jyh-Pyng Gau1,

1 Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital and National Yang Ming University School of Medicine, Taipei, Taiwan
2 Zhongxiao Branch, Taipei City Hospital, Taipei, Taiwan

For reprints and all correspondence: Jyh-Pyng Gau, No. 201, Section 2, Shih-Pai Road, Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan. E-mail: jpgau{at}vghtpe.gov.tw

Received March 5, 2007; accepted April 17, 2007

Background: The impact of coagulopathy on survival of patients with myeloma has not been studied in detail. We aimed to assess the correlation between activated partial thromboplastin time/prothrombin time at diagnosis and overall survival in myeloma patients.

Methods: Data including activated partial thromboplastin time and prothrombin time obtained before treatment and at the time of diagnosis of multiple myeloma (excluding monoclonal gammopathy of undetermined significance, POEMS syndrome, IgM myeloma and myeloma with amyloidosis) collected from 222 patients were analyzed.

Results: Twenty-one patients (9.5%) had prolonged activated partial thromboplastin time (nine with prolonged a activated partial thromboplastin time alone, 12 with both prolonged activated partial thromboplastin time and prothrombin time) and 10 (4.5%) had prolonged prothrombin time alone. Coagulopathy occurred only in patients with IgA and IgG myeloma but not light-chain disease. Prolonged activated partial thromboplastin time was an independent prognostic factor in IgA and IgG myeloma (median survival = 12.7 months, P = 0.004), while prolonged prothrombin time alone had no impact on survival. Subgroup analysis revealed that prolonged activated partial thromboplastin time indicated less favorable survival in IgA myeloma (P = 0.001), but not the IgG myeloma (P = 0.341). This observation still holds true in IgA myeloma with Durie–Salmon stage II or III (P = 0.002).

Conclusions: The presence of prolonged activated partial thromboplastin time at diagnosis is a prognostic factor indicating poor outcome in the IgA myeloma.

Key Words: activated partial thromboplastin time • coagulation • myeloma • prothrombin time


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