일차성 아밀로이드증의 혈전 발생빈도 및 위험 인자

Abstract

Background: AL amyloidosis may increase the risk for thromboembolism as well as other plasma cell dyscrasias

however, only a few reports have described the clinical features of thromboembolism. This study aimed to elucidate the clinical features of thromboembolic events and to identify risk factors for these events. Methods: Medical records were retrospectively reviewed to define clinically significant thromboembolic events. Results: A total of 106 patients with biopsy-proven AL amyloidosis were included. During a median follow-up of 18.1 months (range, 0.4–166.9 months), 13 thromboembolism events were identified in 13 patients: 9 patients (8.5%) experienced acute cerebral infarction, 2 patients (1.9%) experienced pulmonary embolism, and 2 patients (1.9%) experienced deep vein thrombosis. Patients with higher serum free light chain (FLC) difference (≥375.2 mg/L) or beta-2 microglobulin (B2MG) levels (≥2.94 mg/L) experienced significantly more thromboembolic events than those with lower value according to multivariable analysis (hazard ratio [HR], 3.537 [95% CI, 1.051–11.898], P=0.041 for FLC difference

HR, 19.185 [95% CI, 1.848–199.195], P=0.013 for B2MG). Most thromboembolic events (11/13, 84.6%) occurred within the first year following AL amyloidosis diagnosis. Conclusions: The incidence of thromboembolism was substantial in AL amyloidosis. Higher FLC difference and B2MG levels were risk factors for thromboembolic events.