Multiple Myeloma and Thromboembolism in the Perspective of Age and Performance

Abstract

Introduction: The relation with cancer and thromboembolism (TE) are well documented. Within cancer types, hematological malignancies, especially Multiple Myeloma (MM) show a propensity towards TE with its disease biology, disease burden and treatments. We aimed to evaluate the risk factors of TE and MM with a perspective of age and clinical performance. Methods: Data regarding Eastern Cooperative Oncology Group (ECOG) and Karnofsky performance scores, patient, disease and treatment related properties of patients with MM between 2010 and 2016 were recorded. Results: Of the 125 MM patients, 60 were female (48%) while 65 were male (52%). Median age was 65 years. TE was observed in 28 patients (22.4%). In patients <65 years, poor ECOG and Karnofsky scores were strongly related with TE (p values 0.003 and 0.000). Polypharmacy and LDH elevation were observed to be risk factors in all ages (p values 0.002 and 0.000). In patients with poor ECOG (p=0.005 and 0.037) and Karnofsky performance (p=0.002 and 0.003) while radiotherapy and pneumonia during TE episodes were observed to be risk factors for TE regardless of age and performance (p values 0.016 and 0.000). Antimicrobial use during TE episode was observed to be a risk factor in younger patients (p=0.000) who are fit by both scales while bed rest and presence of fractures were observed as risk factors in younger patients with poor performance scores. Conclusion: Performance assessment should be considered as fundamental for TE evaluation and adequate prophylactic treatment for TE should be commenced in frail young patients.