CiteSeerX — Citation Query Hemostatic abnormalities associated with dysprotidemias. (2022)

Hemostatic abnormalities associated with dysprotidemias. (1973)

by H Lackner

Venue:Semin. Haematol.

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A myeloma paraprotein with specificity for platelet glycoprotein IIIa in a patient with a fatal bleeding

by Giovanni Diminno , Francesco Coraggio , Anna M Cerbone , Anna M Capitanio , Ciro Manzo , Marcello Spina , Paolo Scarpato , Guido M R Dattoli , Pier Luigi Mattioli , Mario Mancini , 1986

"... Abstract Impaired platelet aggregation, normal shape change, and agglutination and normal ATP secretion and thromboxane synthesis in response to high concentrations of thrombin or arachidonic acid were found in a patient with multiple myeloma and hemorrhagic tendency. The purified IgG1 kappa or its ..."

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Abstract Impaired platelet aggregation, normal shape change, and agglutination and normal ATP secretion and thromboxane synthesis in response to high concentrations of thrombin or arachidonic acid were found in a patient with multiple myeloma and hemorrhagic tendency. The purified IgG1 kappa or its F(ab'}2 fragments induced similar changes when added in vitro to plateletrich plasma from normal subjects. In addition, the paraprotein inhibited adhesion to glass microbeads, fibrin clot retraction, and binding of radiolabeled fibrinogen or von Willebrand factor to platelets exposed to thrombin or arachidonic acid without affecting intraplatelet levels of cAMP. The radiolabeled paraprotein bound to an average of 35,000 sites on normal platelets but it bound to <2,000 sites on the platelets from a patient with Glanzmann's thrombasthenia. Immunoprecipitation studies showed that the platelet antigen identified by the paraprotein was the glycoprotein IlIa. Furthermore, binding of radiolabeled prostaglandin El (PGEI) to resting platelets as well as binding of von Willebrand factor to platelets stimulated with ristocetin were entirely normal in the presence of patient's inhibitor. These studies indicate that bleeding occurring in dysproteinemia may be the result of a specific interaction of monoclonal paraproteins with platelets. In addition, our data support the concept that the interaction of fibrinogen and/or von Willebrand factor with the platelet glycoprotein Ilb-IIla complex is essential for effective hemostasis.

unknown title

by unknown authors

"... The AST and ALT reagents both contain lactate dehydro-genase (LDH; EC 1.1.1.27) to convert endogenous pyruvate to lactate before a-ketoglutarate is added to start the aminotransferaae reactions. Analysis of the aberrant sera for pyruvate (1) showed concentrations (range 757-1774 imol/L) high enough ..."

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The AST and ALT reagents both contain lactate dehydro-genase (LDH; EC 1.1.1.27) to convert endogenous pyruvate to lactate before a-ketoglutarate is added to start the aminotransferaae reactions. Analysis of the aberrant sera for pyruvate (1) showed concentrations (range 757-1774 imol/L) high enough to sodeplete NADH that even normal values for AST and ALT would give a nonlinear response and a depletion flag. In ketoacidotic patients, serum pyru-vate increases, owing to uncoupling of oxidative phosphoryl-ation, but why should pyruvate values be high in old specimens? We referred to the reactions outlined by Long (2). If blood specimens are left at room temperature, the following two reactions proceed. Pyruvate + triose phosphate- * lactate +

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158 American Society of Hematology Bleeding and Thrombosis Risks in

by Plasma Cell Dyscrasias, Charles S. Eby

"... Major, spontaneous bleeding is uncommon in patients with plasma cell dyscrasias despite frequent abnor-mal screening hemostasis tests. However, acquired von Willebrand deficiency and light-chain (AL) amyloi-dosis, and amyloidosis complicating multiple myeloma can present with serious hemorrhagic com ..."

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Major, spontaneous bleeding is uncommon in patients with plasma cell dyscrasias despite frequent abnor-mal screening hemostasis tests. However, acquired von Willebrand deficiency and light-chain (AL) amyloi-dosis, and amyloidosis complicating multiple myeloma can present with serious hemorrhagic complications that are challenging to manage. While patients with monoclonal gammapathy of undetermined signifi-cance and multiple myeloma share an intrinsic increased risk of venous thromboembolic events (VTE), treatment with thalidomide and lenalidomide increases the incidence of VTE in certain multiple myeloma patient subsets. Our understanding of the complex interactions among malignant plasma cells, inflammatory and hemostasis pathways, and

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

by Hao-wei Teng, Po-min Chen, Ya-hsu Yang, Jyh-pyng Gau , 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 parti ..."

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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 pro-thrombin 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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Original Article The Prolonged Activated Partial Thromboplastin Time at Diagnosis Indicates Less Favorable Prognosis in IgA Myeloma

by Hao-wei Teng, Po-min Chen, Ya-hsu Yang, Jyh-pyng Gau , 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 parti ..."

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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 pro-thrombin 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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Correlation coeff. (I)

by unknown authors

"... the serum were evaluated by both calibrations. The differ-ence was not significant at the 95 % confidence level for the diluted serum (2.0 ±0.3 vs 2.2 ±0.3 mg/L). We conclude that IC determination of K ions in the serum is not influenced by the Na matrix of the sample. Therefore the calibration proc ..."

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the serum were evaluated by both calibrations. The differ-ence was not significant at the 95 % confidence level for the diluted serum (2.0 ±0.3 vs 2.2 ±0.3 mg/L). We conclude that IC determination of K ions in the serum is not influenced by the Na matrix of the sample. Therefore the calibration process becomes simpler and addition of matrix is unneces-sary. Mean value, mg/L (lOOX dilution)

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