Hematology researchers at McMaster University have uncovered a significant finding that explains why blood clotting can still happen spontaneously and in an odd way even after taking full-dose blood thinners.
Their findings were published in the journal The New England Journal of Medicine.
Researchers discovered some similarities between this novel blood clotting disorder and vaccine-induced immune thrombocytopenia and thrombosis (VITT), a rare but severe clotting disorder brought on by some COVID-19 vaccines that have since been discontinued.
According to the study, even in the absence of established triggers for these antibodies, such as blood thinners (heparin) or previous vaccinations, some patients may experience significant blood clotting because of antibodies that closely mirror those that cause VITT.
A novel condition known as VITT-like monoclonal gammopathy of thrombotic significance (MGTS) has been discovered.
The newly identified disorder has been termed VITT-like monoclonal gammopathy of thrombotic significance (MGTS).
Our study highlights the importance of recognizing and diagnosing this new blood-clotting disorder,
By understanding how to diagnose VITT-like MGTS, we can develop more effective treatment strategies that go beyond traditional anticoagulation.
Theodore (Ted) Warkentin
The Michael G. DeGroote Centre for Transfusion Research’s McMaster Platelet Immunology Laboratory, the only lab in Canada equipped with the entire testing suite needed to describe the VITT-like antibodies that target the PF4 protein, was the site of the specialized testing. Researchers focused on individuals who had inexplicable VITT-like antibodies that were detectable for a year or longer in order to conduct a thorough examination of cases showing atypical blood-clotting even while the patients were using full-dose blood thinners.
Together with the persistent VITT-like reactivities over at least 12 months (which is extremely uncommon for the majority of anti-PF4 antibodies), the analyses revealed the presence of M (monoclonal) proteins, which normally indicate plasma cell disorders. These findings suggest an ongoing pathological process rather than a transient anomaly.
Five patients who received treatment at facilities in Canada, New Zealand, France, Spain, and Germany provided data for the study, which involved a worldwide partnership.
Jing Jing Wang, a collaborator from Flinders University in Australia, was essential in demonstrating that the M proteins are the pathogenic VITT-like antibodies for every patient. In his anti-PF4 reference lab, collaborator Andreas Greinacher of Greifswald University in Germany assisted in locating comparable instances.
The findings of this study underscore our ability to leverage fundamental molecular and biochemical science to unravel disease mechanisms,
This approach enables precise patient diagnosis and informs timely treatment strategies, even for previously unidentified diseases, exemplifying true bench-to-bedside translational medicine.
Ishac Nazy
Unusual medicines such plasma cell-targeted myeloma therapy, Bruton tyrosine kinase inhibitors (ibrutinib), and high-dose intravenous immunoglobulin (IVIG) showed some benefit, despite the fact that all of the patients had failed blood thinning medications. The emergence of this new blood clotting condition has significant ramifications for how medical professionals will assess individuals who experience uncommon or challenging-to-treat blood clots in the future.
Source: McMaster University
Journal Reference: Wang, Jing Jing et al. “VITT-like Monoclonal Gammopathy of Thrombotic Significance.” The New England journal of medicine, 10.1056/NEJMoa2415930. 12 Feb. 2025, DOI: 10.1056/NEJMoa2415930
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