ISSN 2997-1036
International Journal of Hematology | Vol. 8, No. 2, February 2017 | pp. 9–16
DOI: 10.46882/2017/IJH/000086
Original Article
Title: Evaluation of baseline plasma D-dimer levels as a prognostic predictor in patients presenting with multiple myeloma
Names of Authors: E. F. Chinedu¹, G. H. Haruna², I. J. Balogun³
Authors’ Affiliations: ¹Department of Haematology, University of Nigeria Teaching Hospital, Enugu, Nigeria; ²Department of Medicine, Lagos State University Teaching Hospital, Ikeja, Nigeria; ³Department of Chemical Pathology, University of Ilorin, Ilorin, Nigeria
Abstract: Plasma cell dyscrasias induce a profound hypercoagulable state due to tumor-associated cytokine cascades and endothelial activation, yet the clinical utility of D-dimer as an independent survival predictor remains under-studied. This prospective study evaluated baseline plasma D-dimer concentrations in 54 newly diagnosed adult patients with multiple myeloma to track correlations with the International Staging System (ISS) and 1-year progression-free survival outcomes. Plasma D-dimer was quantified via immunoturbidimetric assays before initiating standard bortezomib-based induction chemotherapy. Elevated baseline D-dimer (> 1.50 mg/L) was detected in 29.6% (16 of 54) of the myeloma patients. Multivariable Cox proportional hazards regression analysis identified an elevated baseline D-dimer concentration as an independent predictor of premature mortality and early disease progression (hazard ratio = 3.42, P < 0.01). Furthermore, high D-dimer levels correlated with advanced tumor stages (ISS Stage III) and an increased prevalence of acute deep vein thrombosis. Pre-treatment plasma D-dimer screening provides valuable prognostic utility, helping clinicians identify multiple myeloma patients at high risk for hypercoagulable complications and aggressive clonal behavior.
Keywords: Multiple myeloma, D-dimer, hypercoagulability, progression-free survival, tumor biomarker
Manuscript Timeline: Received: November 11, 2016; Revised: December 20, 2016; Accepted: January 08, 2017; Published: February 16, 2017