Characteristics and risk factors for thrombosis in POEMS syndrome: A retrospective evaluation of 230 patients

Patrick W. Mellors, Taxiarchis Kourelis, Ronald S. Go, Eli Muchtar, Morie A. Gertz, Shaji K. Kumar, Francis K. Buadi, Prashant Kapoor, Martha Q. Lacy, David Dingli, Yi Hwa, Amie Fonder, Miriam Hobbs, Suzanne Hayman, Rahma Warsame, Nelson R. Leung, Yi Lin, Wilson Gonsalves, Mustaqeem Siddiqui, Robert A. KyleS. Vincent Rajkumar, Angela Dispenzieri

Research output: Contribution to journalArticlepeer-review

Abstract

Thromboses are prevalent in POEMS syndrome, but few risk factors for POEMS-associated thrombosis have been identified. The objective of this study is to identify novel risk factors for POEMS-associated thrombosis. In this retrospective cohort of 230 POEMS patients, 27% developed thrombosis. Arterial events were slightly more common than venous. Stroke accounted for 26% of all thromboses and 53% of arterial events. There were differences in baseline features between the thrombosis group and the no thrombosis group, and these were driven by patients with arterial thrombosis. Risk factors for arterial thrombosis included thrombocytosis, elevated hemoglobin/hematocrit, extravascular volume overload, and splenomegaly. Hyperprolactinemia appeared to be a risk factor for venous thrombosis. The risk of thrombosis was most striking among men with elevated hemoglobin (32% vs. 5%, p <.001) and hematocrit (42% vs. 5%, p <.001) compared to men without. Most thromboses occurred prior to POEMS directed therapy, and most that occurred during therapy happened within 3 months of diagnosis. Twenty-one percent of patients with thrombosis had recurrence. In recognition of high overall rates of thrombosis in this population, all patients with POEMS syndrome should receive prophylactic antiplatelet therapy, and clinicians should consider anticoagulation in patients with risk factors for POEMS-associated thrombosis.

Original languageEnglish (US)
Pages (from-to)209-215
Number of pages7
JournalAmerican journal of hematology
Volume97
Issue number2
DOIs
StateAccepted/In press - 2021

ASJC Scopus subject areas

  • Hematology

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