Objective To explore the correlation between coagulation factor activity and pretreatment bleeding events in patients with a primary diagnosis of multiple myeloma(MM).Methods Totally 42 patients with a first diagnosis of MM admitted to the Department of Hematology of Xinxiang First People's Hospital from April 2022 to August 2023 were selected as the observation group,and 20 patients with dystrophic anemia treated during the same period were selected as the control group.The differences in routine coagulation indicators and the activity of plasma coagulation factors Ⅱ,Ⅴ,Ⅶ,Ⅷ,Ⅸ,Ⅹ,Ⅺand Ⅻ in patients between the two groups were analyzed.According to whether the patients with MM had bleeding events before treatment,they were divided into bleeding group(n=10)and non-bleeding group(n=32).The clinical data and the activity of plasma coagulation factors Ⅱ,Ⅴ,Ⅶ,Ⅷ,Ⅸ,Ⅹ,Ⅺ and Ⅻ in patients between the two groups were compared.The correlation between coagulation factor activity and bleeding in MM patients was analyzed,and the relevant factors affecting bleeding in MM patients were discussed.Results The activity of plasma coagulation factor X of patients in the observation group was significantly lower than that in the control group(P＜0.05),and there was no statistically significant difference in activated partial thromboplastin time(APTT),prothrombin time(PT),thrombin time(TT),fibrinogen(FIB)and D-dimer(D-D)levels as well as the activity of plasma coagulation factors Ⅱ,Ⅴ,Ⅶ,Ⅷ,Ⅸ,Ⅺ and Ⅻ(P＞0.05).Spearman correlation analysis showed that the activity of plasma coagulation factor X of patients in the observation group was negatively correlated with APTT and PT levels(P＜0.05),and not correlated with TT,FIB and D-D(P＞0.05).Among the 42 MM patients,10 patients(23.8％)experienced bleeding events,and 32 patients(76.2％)did not experience bleeding events.There was no statistically significant difference in gender,age,immunophenotyping,Durie-Salmon staging,and underlying diseases in MM patients between the bleeding group and the non-bleeding group(P＞0.05).The proportion of MM patients with subtype A in the bleeding group was significantly lower than that in the non-bleeding group,while the proportion of patients with subtype B was significantly higher than that in the non-bleeding group(P＜0.05).The total proportions of ISS stage Ⅰ and Ⅱ patients in the bleeding group were significantly lower than those in the non-bleeding group,while the proportion of stage Ⅲ patients was significantly higher than that in the non-bleeding group(P＜0.05).The platelet count and the activity of plasma coagulation factor X of MM patients in the bleeding group were significantly lower than those in the non-bleeding group,while APTT,PT and TT were significantly higher than those in the non-bleeding group(P＜0.05).There was no statistically significant difference in FIB,D-D,and the activity of plasma coagulation factors Ⅱ,Ⅴ,Ⅶ,Ⅷ,Ⅸ,Ⅺ and Ⅻ between the two groups(P＞0.05).Conclusion The activity of plasma coagulation factor Ⅹ is significantly reduced in MM patients,which is closely related to the occurrence of bleeding events before treatment.It is clinically necessary to detect the activity of individual coagulation factors in MM patients to comprehensively evaluate patients'coagulation function.
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