Increased risk of deep-vein thrombosis in patients with multiple myeloma receiving thalidomide and chemotherapy

• Published in: Blood Vol. 98; no. 5; pp. 1614 - 1615
• Main Authors: Zangari, Maurizio, Anaissie, Elias, Barlogie, Bart, Badros, Ashraf, Desikan, Raman, Gopal, A. Viju, Morris, Christopher, Toor, Amir, Siegel, Eric, Fink, Louis, Tricot, Guido
• Format: Journal Article
• Language: English
• Published: Washington, DC Elsevier Inc 01.09.2001; The Americain Society of Hematology
• Subjects: Adult; Aged; Anticoagulants - therapeutic use; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Blood Coagulation Factors - analysis; Cisplatin - administration & dosage; Cisplatin - adverse effects; Cyclophosphamide - administration & dosage; Cyclophosphamide - adverse effects; Dexamethasone - administration & dosage; Dexamethasone - adverse effects; Doxorubicin - administration & dosage; Doxorubicin - adverse effects; Drug toxicity and drugs side effects treatment; Etoposide - administration & dosage; Etoposide - adverse effects; Female; Humans; Male; Medical sciences; Middle Aged; Multiple Myeloma - complications; Multiple Myeloma - drug therapy; Pharmacology. Drug treatments; Risk; Risk Factors; Thalidomide - administration & dosage; Thalidomide - adverse effects; Toxicity: blood; Venous Thrombosis - drug therapy; Venous Thrombosis - epidemiology; Venous Thrombosis - etiology; Venous Thrombosis - prevention & control; Vincristine - administration & dosage; Vincristine - adverse effects; Antineoplastic agent; Hypercoagulability; Toxicity; Cardiovascular disease; Hemopathy; Anticoagulant; Myeloma; Venous disease; Vascular disease; Prevention; Immunoglobulinopathy; Lymphoproliferative syndrome; Complication; Deep vein; Thalidomide; Human; Immunopathology; Corticosteroid; Drug combination; Dexamethasone; Malignant hemopathy; Thrombosis; Chemotherapy; Treatment; Risk factor; Coagulopathy
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood.V98.5.1614

The occurrence of deep-vein thrombosis (DVT) in patients with newly diagnosed multiple myeloma, who were randomly assigned to receive identical induction chemotherapy with or without thalidomide, are reported in this study. The 2 study arms were comparable with respect to key myeloma prognostic factors and known risk factors for DVT. One hundred patients received induction chemotherapy including 4 cycles of continuous infusion of combinations of dexamethasone, vincristine, doxorubicin, cyclophosphamide, etoposide, and cisplatin, and each patient completed at least one induction cycle. DVT developed in 14 of 50 patients (28%) randomly assigned to receive thalidomide but in only 2 of 50 patients (4%) not given the agent (P = .002). All episodes of DVT occurred during the first 3 cycles of induction. Administration of thalidomide was resumed safely in 75% of patients receiving anticoagulation therapy. Thus, thalidomide given in combination with multiagent chemotherapy and dexamethasone is associated with a significantly increased risk of DVT, which appears to be safely treated with anticoagulation and does not necessarily warrant discontinuation of thalidomide.