Reflections on the unexpected laboratory finding of hemorheological alterations observed in some haematological disorders

Caimi, Gregorio; Presti, Rosalia Lo; Carlisi, Melania

doi:10.1016/j.mvr.2021.104171

Cited by 7 publications

(5 citation statements)

References 34 publications

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“…Indicating the heterogeneity of the volume of erythrocytes, RDW is a simple and immediately inflammatory marker and it reflects the increase of some cytokines, such as IL-6 and tumor necrosis factor-alpha (TNF-alpha), but also of hepcidin in the blood [ 42 , 43 ]. It is possible that the increase in this predictor may affect the erythrocyte deformability of MM patients, also considering that in some of our previous research [ 18 , 19 , 20 , 21 ], this hemorheological determinant was reduced compared with the control group. In this regard, in a cohort of 298 normal adults, some authors found a negative correlation between RDW and erythrocyte deformability, and only when the RDW value exceeded 14% was the reduction of this hemorheological determinant highlighted [ 44 ].…”

Section: Discussionmentioning

confidence: 78%

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Calculated Whole Blood Viscosity and Albumin/Fibrinogen Ratio in Patients with a New Diagnosis of Multiple Myeloma: Relationships with Some Prognostic Predictors

et al. 2023

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Background: In this single center study, we retrospectively evaluated the calculated hemorheological profile in patients with a new diagnosis of multiple myeloma, with the aim to evaluate possible relationships with some prognostic predictors, such as ISS, albumin levels, beta2-microglobulin, red cell distribution width, and bone marrow plasma cell infiltration. Methods: In a cohort of 190 patients, we examined the calculated blood viscosity using the de Simone formula, and the albumin/fibrinogen ratio as a surrogate of erythrocyte aggregation, and then we related these parameters to prognostic factors, using the Kruskal–Wallis and the Mann–Whitney tests, respectively. Results: From our analysis, it emerged that the evaluated hemorheological pattern differed in the three isotypes of multiple myeloma, and the whole blood viscosity was higher in IgA and IgG isotypes with respect to the light chain multiple myeloma (p < 0.001). Moreover, we observed that, as the ISS stage progressed, the albumin/fibrinogen ratio was reduced, and the same hemorheological trend was traced in subgroups with lower albumin levels, higher beta2-microglobulin and red cell distribution width RDW values, and in the presence of a greater bone marrow plasma cell infiltrate. Conclusions: Through the changes in blood viscosity in relation to different prognostic factors, this analysis might underline the role of the hemorheological pattern in multiple myeloma.

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Section: Discussionmentioning

confidence: 78%

“…Finally, in the MM setting, the hemorheological pattern can play a significant role, especially in terms of whole blood viscosity (WBV) and erythrocytes deformability and aggregation [ 18 , 19 , 20 , 21 ].…”

Section: Introductionmentioning

confidence: 99%

Calculated Whole Blood Viscosity and Albumin/Fibrinogen Ratio in Patients with a New Diagnosis of Multiple Myeloma: Relationships with Some Prognostic Predictors

et al. 2023

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“…The presence of a paraprotein may be associated with increased blood viscosity and subsequent slowing of blood flow through the vessels. The hemorheological alteration present in MM and MGUS patients has been attributed to the abnormality of plasma or serum viscosity in contrast to polycythemia vera, where increased blood viscosity is related to an increased mass of red blood cells (RBC) [47]. This is mainly driven by the type and the concentration of M-protein, but data from ex-vivo experiments suggest that RBC properties could play a role as well.…”

Section: Hyperviscosity In Mgus Patientsmentioning

confidence: 99%

Monoclonal Gammopathy of Thrombotic Significance

Gkalea

Fotiou

Dimopoulos

et al. 2023

Cancers

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The current review provides an overview of the thrombotic risk observed in patients with MG who do not otherwise require treatment. We discuss clinical and biomarker studies that highlight the heterogenous hemostatic profile observed in these patients and how knowledge has evolved over the past 20 years. Biomarker studies suggest shared biologic features between multiple myeloma and monoclonal gammopathy of undetermined significance (MGUS), which involves both hypercoagulability and platelet activation. Hemostatic abnormalities identified in MGUS patients cannot be translated into clinical practice as they lack correlation to clinical events. The prothrombotic phenotype of MGUS patients has not been ascertained yet, but novel data on coagulation markers are promising. We also review rare conditions associated with the thrombogenic properties of the monoclonal protein that predispose to arterial, venous or microthrombotic events and demonstrate that the M-protein can be linked to clinically significant thrombotic events. Cryoglobulinemia, cryofibrinogenemia, cryo-crystaloglobulinemia and MG-related antiphospholipid syndrome are reviewed. We propose the new umbrella term “monoclonal gammopathy of thrombotic significance” (MGTS) to refer to significant, recurrent thrombotic events in patients with MGUS that provide a rationale for targeting the underlying plasma cell clone. Identifying MGUS patients at high risk for thrombotic events is currently a challenge.

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“…So far, the alteration of blood viscosity that usually accompanies and characterizes the plasma cell dyscrasias [76][77][78][79][80][81][82] has not been mentioned among the pathogenetic hypotheses considered to explain the hemodynamic condition underlying the HOHF. In addition to the close relationship between hemorheological determinants and microcirculation [83], of particular interest are the links between the hemorheological profile and endothelial function, which have been discussed a lot so far [84][85][86].…”

Section: Hemorheological Alterationsmentioning

confidence: 99%

High Output Heart Failure in Multiple Myeloma: Pathogenetic Considerations

Carlisi

Mancuso

Presti

et al. 2022

Cancers

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The high output heart failure is a clinical condition in which the systemic congestion is associated to a high output state, and it can be observed in a non-negligible percentage of hematological diseases, particularly in multiple myeloma, a condition in which the risk of adverse cardiovascular events may increase, with a worse prognosis for patients. For this reason, though an accurate literature search, we provided in this review a complete overview of different pathogenetic mechanisms responsible for high output heart failure in multiple myeloma. Indeed, this clinical finding is present in the 8% of multiple myeloma patients, and it may be caused by artero-venous shunts, enhanced angiogenesis, glutamminolysis, hyperammonemia and hemorheological alterations with increase in plasma viscosity. The high output heart failure in multiple myeloma is associated with significant morbidity and mortality, emphasizing the need for a multidisciplinary approach.

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Reflections on the unexpected laboratory finding of hemorheological alterations observed in some haematological disorders

Cited by 7 publications

References 34 publications

Calculated Whole Blood Viscosity and Albumin/Fibrinogen Ratio in Patients with a New Diagnosis of Multiple Myeloma: Relationships with Some Prognostic Predictors

Calculated Whole Blood Viscosity and Albumin/Fibrinogen Ratio in Patients with a New Diagnosis of Multiple Myeloma: Relationships with Some Prognostic Predictors

Monoclonal Gammopathy of Thrombotic Significance

High Output Heart Failure in Multiple Myeloma: Pathogenetic Considerations

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