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多发性骨髓瘤（MM)是一种骨髓内浆细胞异常增生的恶性肿瘤，其并发血栓事件的风险很高，尤其是MM 患者静脉血栓（VTE)的发生率明显高于一般人群。另外，近年来国内外研究证明新型的免疫调节药物(IMiDs)在MM患者中的应用，如沙利度胺及其类似物来那度胺也可导致与治疗相关的静脉血栓发生的增加，特别是与大剂量的地塞米松和（或）蒽环类抗生素为基础的化疗药联合使用时，可进一步加剧静脉血栓的发生。目前，MM患者VTE 的发生机制仍不太清楚，可能涉及凝血系统的激活，纤维蛋白溶解功能的异常，血流及血液瘀滞度的改变及与肿瘤细胞相关的炎症因子产生的增多，组织因子（TF)表达增加，内皮细胞损伤等。因此，仍需对在MM患者中VTE 的发生机制做更进一步的研究。而本文将主要从多发性骨髓瘤本身及免疫调节药物的应用所引起的凝血功能异常而致静脉血栓形成这一机制做一综述。

英文摘要:

Multiple myeloma is a kind of malignant neoplasm that is characterized by the abnormal proliferation of malignant plasma cells in the bone marrow. Multiple myeloma poses an increased risk for thrombotic events, especially patients with Multiple myeloma are at increased risk of veinous thromboembolism compared to the general population. In addition, there is a foreign and domestic study evidences that the introduction of novel immunomodulatory drugs, such as thalidomide and its analogue lenalidomide, substantially increases treatment-related incidence of veinous thromboembolism, especially when used in combination with high-dose dexamethasone and/or anthracycline-based chemotherapy, which further increases veinous thromboembolism. Currently the mechanisms of Multiple myeloma on veinous thromboembolism are not still well-understood, but probably involves the activation of coagulation system, fibrinolytic dysfunction, the change of blood stream and stasis and increased inflammatory cytokines, expression of tissue factor and damaged endothelial cells that related to the tumor cells. Therefore, further studies to investigate the pathogenesis of veinous thromboembolismin Multiple myeloma are warranted. However, in this article, we will make a concrete review about Multiple myeloma itself and the application of immunomodulatory drugs which cause veinous thromboembolism through the mechanism of the coagulant dysfunction.

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