Treatment of multiple myeloma and arterial thrombosis

Raven, Wouter; Berghout, A; Houten, Anja van; Leebeek, Frank W.G.

doi:10.1007/s00277-009-0803-x

Cited by 5 publications

(6 citation statements)

References 10 publications

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“…Only few cases of arterial thrombosis (acute myocardial infarction, ischemic stroke, transitory ischemic attack, and distal arterial thrombosis) have been reported in MM patients. 127,128 These events predominantly occurred in patients treated with thalidomide. The risk of arterial thrombosis was recently evaluated in a prospective study of 195 consecutive patients aged 18 to 65 years with newly diagnosed MM.…”

Section: Bleeding Manifestations: Clinical Impact and Managementmentioning

confidence: 99%

“…The risk of arterial thrombosis was recently evaluated in a prospective study of 195 consecutive patients aged 18 to 65 years with newly diagnosed MM. 127 Patients were treated with three cycles of vincristine, doxorubicin and dexamethasone (VAD) or thalidomide-AD (TAD) or bortezomib-AD (PAD), followed by high-dose melphalan and autologous stem cell transplantation. Of 195 patients, 11 (5.6%) developed arterial thromboses, with the highest incidence of the events during and after induction chemotherapy.…”

Section: Bleeding Manifestations: Clinical Impact and Managementmentioning

confidence: 99%

“…134,138,139 On the Figure 4 Recommendations for thromboprophylaxis in patients with multiple myeloma receiving thalidomide or lenalidomide by the International Myeloma Working Group. 127 Therapeutic choice is based on a risk-assessment model taking into account the patient-and treatment-related risk factors (high-dose dexamethasone, anthracycline, use of erythropoietin stimulating agents, central venous catheters, age, comorbidities such as diabetes or infections, active cardiovascular disease, immobility, previous thrombotic events, inherited thrombophilia). During treatment additional risk conditions may occur, leading to shifting thromboprophylaxis with aspirin to low molecular weight heparin (LMWH) in previously considered low-risk patients.…”

Section: Bleeding Manifestations: Clinical Impact and Managementmentioning

confidence: 99%

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Bleeding and Thrombosis in Multiple Myeloma and Related Plasma Cell Disorders

Coppola

Tufano²,

Capua³

et al. 2011

Semin Thromb Hemost

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A variety of disease- and treatment-related factors affect the coagulation system and the risk of bleeding and thrombotic complications in patients with multiple myeloma (MM) and related plasma cell disorders (PCD). As commonly observed in other cancer settings, the malignant clone induces a cytokine environment responsible for a hypercoagulable state. The increase of blood viscosity and impairment of platelet and coagulation function due to circulating monoclonal proteins are considered key mechanisms in the hemostatic abnormalities frequently detected in patients with PCD. However, clinically significant bleeding is relatively rare and poorly correlated with these abnormalities. Management is often challenging because of the multifactorial pathogenesis and underestimation or misdiagnosis of acquired bleeding disorders, particularly acquired von Willebrand syndrome. In recent years, growing interest in thromboembolic risk has emerged after the introduction of novel and more effective antimyeloma agents (thalidomide and lenalidomide), which was associated with increased risk of venous thromboembolism, particularly when associated with dexamethasone and multiagent chemotherapy in newly diagnosed patients. The clinical impact of bleeding and thrombotic complications in patients with PCD, with emphasis on MM, will be discussed in this review, reporting the current knowledge about pathophysiologic mechanisms and implications for management.

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Section: Bleeding Manifestations: Clinical Impact and Managementmentioning

confidence: 99%

Section: Bleeding Manifestations: Clinical Impact and Managementmentioning

confidence: 99%

Section: Bleeding Manifestations: Clinical Impact and Managementmentioning

confidence: 99%

See 1 more Smart Citation

Bleeding and Thrombosis in Multiple Myeloma and Related Plasma Cell Disorders

Coppola

Tufano²,

Capua³

et al. 2011

Semin Thromb Hemost

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“…[2][3][4] Only a few cases of arterial thrombosis have been reported in multiple myeloma patients and the true incidence of arterial thrombosis in MM is not known. [5][6][7][8][9] Case reports of patients treated with thalidomide suggested that arterial thrombosis may be an adverse effect of this drug, which has been reported to increase the rate of venous thromboembolism. We performed a prospective analysis of arterial thrombosis in a cohort of newly diagnosed MM patients who were transplantation candidates and were included in national trials for induction chemotherapy followed by high-dose melphalan (HDM) with autologous stem cell transplantation.…”

Section: Introductionmentioning

confidence: 99%

High incidence of arterial thrombosis in young patients treated for multiple myeloma: results of a prospective cohort study

Libourel¹,

Sonneveld²,

Holt³

et al. 2010

Blood

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“…The majority of thrombotic events described in patients receiving treatment with thalidomide have been venous, but occasional arterial thrombotic events have also been reported [60][61][62][63]. In a prospective analysis of arterial thrombosis risk, the incidence of arterial thrombosis in patients with newly diagnosed MM treated with three cycles of thalidomide, doxorubicin and dexamethasone (TAD group) was 4.5%.…”

Section: Thalidomide and Thrombosismentioning

confidence: 99%