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Cell environment coupled with the effect of the monoclonal protein on fibrin formation may potentiate a thrombogenic state in mgus. online sale viagra The role of known hereditary and acquired defects predisposing to hypercoagulability is still being examined in this population of patients. None of the other variables examined in the univariate analysis, such as type of underlying illness, platelet count or fibrinogen level, were associated with an increase risk for vtd in this study. These findings do not favor a role for chronic inflammation as a precipitating event for clotting in this group of patients. Collectively, our results indicate that, not unlike patients with multiple myeloma, patients with mgus are at increased risk for vtd. Also not unlike myeloma, the thrombotic episodes observed in patients with mgus are very well managed with anticoagulant therapy. A key concept to keep in mind when examining the findings of our study is the view of mgus and multiple myeloma as a continuum rather than as separate entities. This is true in at least 25% of patients with mgus who progress to a plasma cell disorder. The implication here is two-fold. First, some patients with mgus, e. G. viagra discount sales Those with a high concentration of m-protein, are at increased risk both for vtd and progression to myeloma. Secondly, and most importantly, it is possible that a diagnosis of vtd in a patient with mgus may in fact portend a higher risk for transformation to myeloma in the future. In summary, this is the first study that provides evidence for the presence of a hypercoagulable state in mgus. Future long-term studies are important to confirm our findings. buy viagra cheap In particular, research efforts should be directed toward resolving the mechanism for the predisposition to thrombosis in both mgus and multiple myeloma. â© 2004 european society for medical oncology previous section â  references 1. buy generic viagra online ↵ zangari m, anaissie e, barlogie b et al. Increased risk of deep vein thrombosis in patients with multiple myeloma receiving thalidomide and chemotherapy. common ingredients viagra Blood 2001; 98: 1614–1615. Abstract / free full text 2. ↵ zangari m, siegel e, barlogie b et al. Thrombogenic activity of doxorubicin in myeloma patients receiving thalidomide: implications for therapy. Blood 2002; 100: 1168–1171. viagra for sale uk Abstract / free full text 3. ↵ minnema mc, fijnheer r, de groot pg, lokhorst hm. Extremely high levels of von willebrand factor antigen and of procoagulant factor viii found in multiple myeloma patients are associated with activity status but not with thalidomide treatment. J thromb haemost 2003; 1: 445–449. Crossref medline web of science 4. there free samples viagra ↵ kyle ra, therneau tm, rajkumar sv et al. best place to buy generic viagra online A long-term study of prognosis in monoclonal gammopat. viagra generic ¬© John Benson 2012