PB1403 - Impact of determining clinical risk factors and biomarkers on the risk of cancer-associated thrombosis in newly diagnosed patients with multiple myeloma. The observational Roadmap-CAT-MM

Tuesday, June 25, 2024

13:45 – 14:45 ICT

Room: Exhibition Hall

Presenting Author(s)

Patrick Van Dreden, PhD

Clinical Research Manager
Diagnostica Stago
Gennevilliers, Ile-de-France, France

Co-Author(s)

el

eleftheria lefkou

biologist
INSERM
thessaloniki, Thessaloniki, Greece
dF

despina Fotiou

PhD
National and kapodistrian University of Athens
athens, Attiki, Greece
eT

evangelos Terpos

biologist
National and kapodistrian University of Athens
athens, Attiki, Greece
ek

efstathios kastritis

PhD clinical research manager
National and Kapodistrian University of Athens
Athens, Attiki, Greece
ar

aurélie rousseau

PhD clinical research manager
Diagnostica STAGO
gennevilliers, Ile-de-France, France
MD

Meletios A Dimopoulos

Pr
Hematology and medical oncology National and kapodistrian university of Athens
Athens, Attiki, Greece
GG

Grigorios Gerotziafas

Pr
Sorbonne University, INSERM UMR_S_938, Saint-Antoine Research Center, CRSA, Team "Cancer Biology and Therapeutics", Group "Cancer - Angiogenesis - Haemostasis", Institut Universitaire de Cancérologie, AP-HP, Saint-Antoine Hospital, Paris, France.
Paris, Ile-de-France, France

Background: Hypercoagulability is a common blood alteration in newly diagnosed chemotherapy naïve patients with multiple myeloma. The rate of VTE is higher at the time of diagnosis and during the first months following initiation of first line therapy. The exact mechanism of the increased risk of VTE is not yet fully understood

Aims: The observational Roadmap-CAT-MM explore the relationship of MM with cellular and plasma hypercoagulability as well as tissue factor positive microparticles, aiming to identify the most relevant biomarkers, which could be used in RAM for VTE in combination with clinical risk factors.

Methods: Newly diagnosed patients (182) with multiple myeloma (NDMM) were enrolled. Patients were followed up for 12 months and the primary end-point was symptomatic objectively confirmed VTE. Patients were risk stratifled and received thromboprophylaxis (none, aspirin on low molecular weight heparin (LMWH). Thrombin generation (TGT) , P-Selectin, heparanase, procoagulant phospholipids , Factor VIia , D-Dimers (DDi) ,Tissue Factor activity (TFa), MPC-derived microparticles (MPC dMPs) measured and compared against healthy individuals (n=30).

Results: At inclusion, patients showed significantly increased levels of TFa, FVlla, D-Dimers and FM, and significantly shorter Procoag-PPL as compared to the control group. Levels of P-selectin and TM were significantly lower in patients. Lag-time and ttPeak were significantly increased and Peak, MRI, and ETP were significantly lower compared to control group, MP-TF activity measured in NDMM significantly increased compared to control subjects (Table 1). Multivariate logistic regression analysis demonstrated that ETP, Procoag-PPL and MP-TF were independently associated with VTE occurrence. (Table 2)

Conclusion(s): The ROADMAP-CAT-MM study shown pronounced cellular hypercoagulability in NDMM characterized by decreased Procoag PPL, enhanced endothelial cell activation, and exhausted thrombin generation. The Procoag-PPL clotting time and the ETP and MP-TF were found to be independently associated with the risk of VTE and can be prospectively incorporated into a RAM for VTE in MM.