Multiple myeloma(MM)is a malignancy characterized by the abnormal proliferation of clonal plasma cells.It is often associated with coagulation abnormalities,posing risks of thrombosis,thromboembolism,and bleeding,including severe cases,which are related to de-creased quality of life,delayed or discontinued treatment,and reduced survival.Disease,individual-specific factors,and therapeutic agents affect the dynamic balance of coagulation,anticoagulation,and fibrinolytic systems in patients with MM.The diagnosis and treatment of un-derlying coagulation disorders are challenging due to the involvement of multiple mechanisms.In addition,newly introduced therapies such as immunomodulatory drugs,proteasome inhibitors,chimeric antigen receptor-modified T-cell therapy,and monoclonal antibodies also im-pact coagulation in patients with MM.This review discusses the influencing factors,pathophysiological mechanisms,and prevention and treatment strategies for coagulation abnormalities in MM.

Multiple myeloma(MM)is a malignancy characterized by the abnormal proliferation of clonal plasma cells.It is often associated with coagulation abnormalities,posing risks of thrombosis,thromboembolism,and bleeding,including severe cases,which are related to de-creased quality of life,delayed or discontinued treatment,and reduced survival.Disease,individual-specific factors,and therapeutic agents affect the dynamic balance of coagulation,anticoagulation,and fibrinolytic systems in patients with MM.The diagnosis and treatment of un-derlying coagulation disorders are challenging due to the involvement of multiple mechanisms.In addition,newly introduced therapies such as immunomodulatory drugs,proteasome inhibitors,chimeric antigen receptor-modified T-cell therapy,and monoclonal antibodies also im-pact coagulation in patients with MM.This review discusses the influencing factors,pathophysiological mechanisms,and prevention and treatment strategies for coagulation abnormalities in MM.