Rates of venous thromboembolism in multiple myeloma patients undergoing immunomodulatory therapy with thalidomide or lenalidomide: a systematic review and meta-analysis
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作者:
Carrier, M.
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Univ Ottawa, Dept Med, Div Hematol, Thrombosis Program, Ottawa, ON, CanadaUniv British Columbia, Div Hematol, Diamond Hlth Care Ctr, Thrombosis Program,Dept Med, Vancouver, BC V5Z 1M9, Canada
Carrier, M.
[2
]
Le Gal, G.
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Brest Univ Hosp, Dept Internal Med & Chest Dis, EA3878, Brest, FranceUniv British Columbia, Div Hematol, Diamond Hlth Care Ctr, Thrombosis Program,Dept Med, Vancouver, BC V5Z 1M9, Canada
Le Gal, G.
[3
]
Tay, J.
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Univ Ottawa, Malignant Hematol Program, Div Hematol, Dept Med, Ottawa, ON, CanadaUniv British Columbia, Div Hematol, Diamond Hlth Care Ctr, Thrombosis Program,Dept Med, Vancouver, BC V5Z 1M9, Canada
Tay, J.
[4
]
Wu, C.
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McMaster Univ, Dept Med, Hamilton, ON, CanadaUniv British Columbia, Div Hematol, Diamond Hlth Care Ctr, Thrombosis Program,Dept Med, Vancouver, BC V5Z 1M9, Canada
Wu, C.
[5
]
Lee, A. Y.
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Univ British Columbia, Div Hematol, Diamond Hlth Care Ctr, Thrombosis Program,Dept Med, Vancouver, BC V5Z 1M9, CanadaUniv British Columbia, Div Hematol, Diamond Hlth Care Ctr, Thrombosis Program,Dept Med, Vancouver, BC V5Z 1M9, Canada
Lee, A. Y.
[1
]
机构:
[1] Univ British Columbia, Div Hematol, Diamond Hlth Care Ctr, Thrombosis Program,Dept Med, Vancouver, BC V5Z 1M9, Canada
[2] Univ Ottawa, Dept Med, Div Hematol, Thrombosis Program, Ottawa, ON, Canada
[3] Brest Univ Hosp, Dept Internal Med & Chest Dis, EA3878, Brest, France
[4] Univ Ottawa, Malignant Hematol Program, Div Hematol, Dept Med, Ottawa, ON, Canada
Introduction: The incidence of venous thromboembolism (VTE) in patients with multiple myeloma (MM) treated with thalidomide-and lenalidomide-based regimens is high. Recent observational studies have suggested that thromboprophylaxis might be efficacious in decreasing the risk of VTE in this population. Purpose: To determine the absolute rates of VTE with and without different thromboprophylactic agents in patients with newly diagnosed or previously treated MM receiving thalidomide-or lenalidomide-based regimens. Results: Patients with newly diagnosed MM treated with thalidomide in combination with dexamethasone have a VTE risk of 4.1 (95% CI, 2.8-5.9) per 100 patient-cycles. Therapeutic doses of anticoagulants seem to provide the largest absolute risk reduction of VTE. The rate of VTE in patients with previously treated MM receiving thalidomide in combination with dexamethasone is 0.8 (95% CI, 0.1-2.1) per 100 patient months. A combination of lenalidomide and dexamethasone is associated with of risk of VTE of 0.8 (95% CI, 0.07-2.0) per 100 patient-cycles and 0.7 (95% CI, 0.4-0.9) per 100 patient-cycles in patients with newly diagnosed and previously treated MM, respectively. Similarly, the rates of VTE in patients also receiving thromboprophylaxis with aspirin were 0.9 (95% CI, 0.5-1.5) and 0.6 (95% CI, 0.01-2.1), respectively. Conclusion: Patients with newly diagnosed or previously treated MM receiving thalidomide-or lenalidomide-based regimens in combination with dexamethasone are at high risk of VTE. The benefit of various types of thromboprophylaxis is difficult to quantify in patients with MM receiving immunomodulatory therapy, especially in those receiving lenalidomide-based therapy or who have previously treated MM. Randomized controlled trials are needed to address this important clinical need.
机构:
Wayne State Univ, Karamos Canc Inst, Detroit, MI 48202 USAWayne State Univ, Karamos Canc Inst, Detroit, MI 48202 USA
Zonder, Jeffrey A.
Crowley, John
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Ctr Stat, SW Oncol Grp, Seattle, WA USAWayne State Univ, Karamos Canc Inst, Detroit, MI 48202 USA
Crowley, John
Hussein, Mohamad A.
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H Lee Moffitt Canc Ctr & Res Inst, Tampa, FL USAWayne State Univ, Karamos Canc Inst, Detroit, MI 48202 USA
Hussein, Mohamad A.
Bolejack, Vanessa
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Ctr Stat, SW Oncol Grp, Seattle, WA USAWayne State Univ, Karamos Canc Inst, Detroit, MI 48202 USA
Bolejack, Vanessa
Moore, Dennis F., Sr.
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Wichita Community Clin Oncol Program, Wichita, KS USAWayne State Univ, Karamos Canc Inst, Detroit, MI 48202 USA
Moore, Dennis F., Sr.
Whittenberger, Brock F.
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机构:Wayne State Univ, Karamos Canc Inst, Detroit, MI 48202 USA
Whittenberger, Brock F.
Abidi, Muneer H.
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机构:
Wayne State Univ, Karamos Canc Inst, Detroit, MI 48202 USA
Montana Community Clin Oncol Program, Billings, MT USAWayne State Univ, Karamos Canc Inst, Detroit, MI 48202 USA
Abidi, Muneer H.
Durie, Brian G. M.
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Salick Healthcare Inc, Los Angeles, CA USAWayne State Univ, Karamos Canc Inst, Detroit, MI 48202 USA
Durie, Brian G. M.
Barlogie, Bart
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Univ Arkansas Med Sci, Little Rock, AR USAWayne State Univ, Karamos Canc Inst, Detroit, MI 48202 USA
机构:
Wayne State Univ, Karamos Canc Inst, Detroit, MI 48202 USAWayne State Univ, Karamos Canc Inst, Detroit, MI 48202 USA
Zonder, Jeffrey A.
Crowley, John
论文数: 0引用数: 0
h-index: 0
机构:
Ctr Stat, SW Oncol Grp, Seattle, WA USAWayne State Univ, Karamos Canc Inst, Detroit, MI 48202 USA
Crowley, John
Hussein, Mohamad A.
论文数: 0引用数: 0
h-index: 0
机构:
H Lee Moffitt Canc Ctr & Res Inst, Tampa, FL USAWayne State Univ, Karamos Canc Inst, Detroit, MI 48202 USA
Hussein, Mohamad A.
Bolejack, Vanessa
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h-index: 0
机构:
Ctr Stat, SW Oncol Grp, Seattle, WA USAWayne State Univ, Karamos Canc Inst, Detroit, MI 48202 USA
Bolejack, Vanessa
Moore, Dennis F., Sr.
论文数: 0引用数: 0
h-index: 0
机构:
Wichita Community Clin Oncol Program, Wichita, KS USAWayne State Univ, Karamos Canc Inst, Detroit, MI 48202 USA
Moore, Dennis F., Sr.
Whittenberger, Brock F.
论文数: 0引用数: 0
h-index: 0
机构:Wayne State Univ, Karamos Canc Inst, Detroit, MI 48202 USA
Whittenberger, Brock F.
Abidi, Muneer H.
论文数: 0引用数: 0
h-index: 0
机构:
Wayne State Univ, Karamos Canc Inst, Detroit, MI 48202 USA
Montana Community Clin Oncol Program, Billings, MT USAWayne State Univ, Karamos Canc Inst, Detroit, MI 48202 USA
Abidi, Muneer H.
Durie, Brian G. M.
论文数: 0引用数: 0
h-index: 0
机构:
Salick Healthcare Inc, Los Angeles, CA USAWayne State Univ, Karamos Canc Inst, Detroit, MI 48202 USA
Durie, Brian G. M.
Barlogie, Bart
论文数: 0引用数: 0
h-index: 0
机构:
Univ Arkansas Med Sci, Little Rock, AR USAWayne State Univ, Karamos Canc Inst, Detroit, MI 48202 USA