Myeloma, IMiDs and thrombosis

Immunomodulatory drugs (IMiDs) take part in the significant improvement in the management of multiple myeloma. The introduction of IMiDs in Myeloma therapy has also dramatically increased the incidence of thromboembolic events, both venous and/or arterial, that could reach up to 30 to 50 % in some clinical trials without thromboprophylaxis. This observation made it compulsory to examine thromboprophylactic options in myeloma, particularly in patients treated with IMiDs. International guidelines addressed this issue but evidence remains scarce. We have reviewed evidences in order to help determine what risk factors we ought to take into consideration and what type of thromboprophylaxis we should offer when managing patients with IMiDs.