Meta-Analysis: The Significance of Thrombosis in Multiple Myeloma

By Patrick Daly - Last Updated: April 12, 2023

Citing that patients with multiple myeloma (MM) have a high risk for thrombosis and thromboembolism, particularly those on immunomodulators, researchers conducted a meta-analysis to define the prognostic significance of thrombosis in MM. The study was presented in Translational Cancer Research.

The study’s authors found lower levels of β2 microglobulin in patients with MM and venous thromboembolism (VTE). Furthermore, patients with VTE were associated with worse prognoses and mortality rates compared to those without VTE, and patients with arterial thromboembolism had increased mortality compared to those without.

β2 Microglobulin Associated With Thrombosis in Multiple Myeloma

The investigators enrolled 9 studies encompassing 38,047 patients with MM and 6412 recorded thrombotic events, published to PubMed, Embase, Web of Science, Wanfang, and China National Knowledge Infrastructure databases by May 2022.

The primary analysis was thrombosis in MM and its association with overall survival (OS), progression-free survival (PFS), event-free survival (EFS), and mortality.

According to the report, β2 microglobulin levels modified the incidence of thrombosis in MM with a standard mean difference of -0.09 (95% CI, -0.18 to -0.01; P=.02). In addition, VTE in MM was associated with poorer OS (hazard ratio [HR], 0.79; 95CI, 0.64-0.98; P=.03) and increased early mortality (HR, 2.27; 95% CI, 1.26-4.08; P=.006).

PFS and EFS were not significantly different between patients with or without VTE, though arterial thromboembolism was associated with significantly increased mortality at 5 years (HR, 1.89; 95% CI, 133-2.69; P<.01).

To conclude, the authors found β2 microglobulin levels may predict thrombosis in MM, and thrombosis was linked to worse survival outcomes. The report suggested that “MM patients with high thrombosis risk should receive anticoagulant therapy.”

Related: Predicting Cardiovascular Adverse Events in Multiple Myeloma

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