多發性骨髓瘤合并動靜脈血栓形成一例及文獻復習_《華西醫學》

作者：

王欣 ^1,2 , 黃杰 ¹ , 鄧承祺 ¹ , 羊裔明 ¹ ,  牛挺 ¹

1四川大學華西醫院血液科及血液學研究室（成都，610041）;2遂寧市中心醫院血液科;

關鍵詞：

多發性骨髓瘤合并癥血栓形成診斷治療

DOI：

CNKI: 51-1356/R.20120215.1036.001

視頻：

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目的　提高對多發性骨髓瘤合并動靜脈血栓形成的臨床診治水平。方法　報道1例表現為反復胸腔積液，同時合并反復、多處靜脈和動脈血栓形成患者的臨床資料，并復習文獻。結果　該例62歲老年女性患者，合并右側下肢靜脈、腎動脈、腦動脈、頸動脈、肺動脈血栓反復形成，檢查后明確診斷為多發性骨髓瘤IgG λ型、原發性淀粉樣變，合并多處動靜脈血栓形成，給予美法侖+潑尼松（MP）方案化療和抗血小板、抗凝治療后癥狀改善，隨訪13個月病情穩定，無新發血栓形成。結論　多發性骨髓瘤可能合并動靜脈血栓形成等不典型表現，需要進一步提高認識。

引用本文： 王欣,黃杰,鄧承祺,羊裔明,牛挺. 多發性骨髓瘤合并動靜脈血栓形成一例及文獻復習. 華西醫學, 2012, 27(2): 179-181. doi: CNKI: 51-1356/R.20120215.1036.001 復制

1.	SwSwerdlow SH, Campo E, Harris NL, et al. WHO classification of tumours of haematopoietic and lymphoid tissues[M]. 4th ed. Lyon: International agency for research on ca ncer (IARC) Press, 2008: 202.
2.	Kristinsson SY, Pfeiffer RM, Björkholm M, et al. Arterial and venous thrombosis in monoclonal gammopathy of undetermined significance and multiple myeloma: a population-based study[J]. Blood, 2010, 115(24): 4991-4998.
3.	魏曉娜, 檀金川. 以下肢動脈血栓為首發癥狀的多發性骨髓瘤1例[J]. 臨床薈萃, 2010, 25(7): 619-620.
4.	劉增艷. 多發性骨髓瘤血栓形成及防治的研究進展[J]. 國際輸血及血液學雜志, 2007, 30(6): 499-501.
5.	Auwerda JJ , Sonnevel d P , de-Maat MP, et al. Prothrombotic coagulation abnormalities in patients with newly diagnosed multiple myeloma[J]. Haematologica, 2007, 92(2): 279-280.
6.	Ehce F, Fink L, Tricot G, et al. Acquired resistance to activated proteinC (aAPCR) in multiple myeloma is a transitory abnormality associated with an increased risk of venous thromboembolism[J]. Br J Haematol, 2006, 134(4): 399-405.
7.	Ying KJ, Zhou Y, Jiang H, et al. Multiple myeloma with pulmonary embolism: a case report[J]. Chin Med J (Engl), 2006, 119(17): 1481-1484.
8.	Uaprasert N, Voorhees PM, Mackman N, et al. Venous thromboembolism in multiple myeloma: current perspectives in pathogenesis[J]. Eur J Cancer, 2010, 46(10): 1790-1799.
9.	Barlogie B, Tricot G, Anaissie E, et al. Thalidomide and hematopoietic-cell transplantation for multiple myeloma[J]. N Engl J Med, 2006, 354(10): 1021-1030.
10.	Palumbo A, Cavo M, Bringhen S, et al. A prospective, randomized, phaseⅢ study of enoxaparin versus aspirin versus low-fixed-dose of warfarin in newly diagnosed myeloma patients treated with thalidomide containing regimens[J]. ASH Annual Meeting Abstracts, 2007, 110(11): 310.
11.	Richardson PG, Mitsiades C, Schlossman R, et al. Bortezomib in the front-line treatment of multiple myeloma[J]. Expert Rev Anticancer Ther, 2008, 8(7): 1054-1072.
12.	Kristinsson SY. Thrombosis in multiple myeloma[J]. Hematology, 2010, 2010(1): 437-444.

1. SwSwerdlow SH, Campo E, Harris NL, et al. WHO classification of tumours of haematopoietic and lymphoid tissues[M]. 4th ed. Lyon: International agency for research on ca ncer (IARC) Press, 2008: 202.
2. Kristinsson SY, Pfeiffer RM, Björkholm M, et al. Arterial and venous thrombosis in monoclonal gammopathy of undetermined significance and multiple myeloma: a population-based study[J]. Blood, 2010, 115(24): 4991-4998.
3. 魏曉娜, 檀金川. 以下肢動脈血栓為首發癥狀的多發性骨髓瘤1例[J]. 臨床薈萃, 2010, 25(7): 619-620.
4. 劉增艷. 多發性骨髓瘤血栓形成及防治的研究進展[J]. 國際輸血及血液學雜志, 2007, 30(6): 499-501.
5. Auwerda JJ , Sonnevel d P , de-Maat MP, et al. Prothrombotic coagulation abnormalities in patients with newly diagnosed multiple myeloma[J]. Haematologica, 2007, 92(2): 279-280.
6. Ehce F, Fink L, Tricot G, et al. Acquired resistance to activated proteinC (aAPCR) in multiple myeloma is a transitory abnormality associated with an increased risk of venous thromboembolism[J]. Br J Haematol, 2006, 134(4): 399-405.
7. Ying KJ, Zhou Y, Jiang H, et al. Multiple myeloma with pulmonary embolism: a case report[J]. Chin Med J (Engl), 2006, 119(17): 1481-1484.
8. Uaprasert N, Voorhees PM, Mackman N, et al. Venous thromboembolism in multiple myeloma: current perspectives in pathogenesis[J]. Eur J Cancer, 2010, 46(10): 1790-1799.
9. Barlogie B, Tricot G, Anaissie E, et al. Thalidomide and hematopoietic-cell transplantation for multiple myeloma[J]. N Engl J Med, 2006, 354(10): 1021-1030.
10. Palumbo A, Cavo M, Bringhen S, et al. A prospective, randomized, phaseⅢ study of enoxaparin versus aspirin versus low-fixed-dose of warfarin in newly diagnosed myeloma patients treated with thalidomide containing regimens[J]. ASH Annual Meeting Abstracts, 2007, 110(11): 310.
11. Richardson PG, Mitsiades C, Schlossman R, et al. Bortezomib in the front-line treatment of multiple myeloma[J]. Expert Rev Anticancer Ther, 2008, 8(7): 1054-1072.
12. Kristinsson SY. Thrombosis in multiple myeloma[J]. Hematology, 2010, 2010(1): 437-444.

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多發性骨髓瘤合并動靜脈血栓形成一例及文獻復習

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《華西醫學》

多發性骨髓瘤合并動靜脈血栓形成一例及文獻復習

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