TY - JOUR
T1 - Optimizing Thromboembolism Prophylaxis for the Contemporary Age of Multiple Myeloma
AU - Baljevic, Muhamed
AU - Sborov, Douglas W.
AU - Lim, Ming Y.
AU - Hillengass, Jens
AU - Martin, Thomas
AU - Castillo, Jorge J.
AU - Streiff, Michael B.
AU - Kumar, Shaji K.
AU - Callander, Natalie S.
N1 - Publisher Copyright:
© 2022 Harborside Press. All rights reserved.
PY - 2022/1
Y1 - 2022/1
N2 - Venous thromboembolism (VTE) is a major complication in all patients with cancer. Compared with the general population, patients withmultiple myeloma (MM) have a 9-fold increase in VTE risk, likely because of their malignancy, its treatments, and other additional patientrelated factors. In MM, thromboembolism events tend to occur within 6 months of treatment initiation, regardless of treatment regimen; however, the use of immunomodulatory agents such as thalidomide or lenalidomide, especially in combination with dexamethasone or multiagent chemotherapy, is known to create a significant risk for VTE. Currently, official recommendations for VTE prophylaxis inMM outlined in various national guidelines or multidisciplinary society panels are based on expert opinion, because data from randomized controlled trials are scarce. Large studies which have mainly focused on the efficacy of thromboprophylaxis in patients with cancer at higher risk for VTE either had a very low representation of patients with MM, or excluded them all together, limiting our ability to draw evidencebased conclusions on how to effectively protect MM population from VTE. In this brief perspective, we highlight some of the greatest challenges that have hampered the field concerning the availability of high-quality clinical trial data for the formulation of best VTE prophylaxis strategies in patients with newly diagnosed MM, as well as the rationale for the latest updates in the NCCN Guidelines on this topic.
AB - Venous thromboembolism (VTE) is a major complication in all patients with cancer. Compared with the general population, patients withmultiple myeloma (MM) have a 9-fold increase in VTE risk, likely because of their malignancy, its treatments, and other additional patientrelated factors. In MM, thromboembolism events tend to occur within 6 months of treatment initiation, regardless of treatment regimen; however, the use of immunomodulatory agents such as thalidomide or lenalidomide, especially in combination with dexamethasone or multiagent chemotherapy, is known to create a significant risk for VTE. Currently, official recommendations for VTE prophylaxis inMM outlined in various national guidelines or multidisciplinary society panels are based on expert opinion, because data from randomized controlled trials are scarce. Large studies which have mainly focused on the efficacy of thromboprophylaxis in patients with cancer at higher risk for VTE either had a very low representation of patients with MM, or excluded them all together, limiting our ability to draw evidencebased conclusions on how to effectively protect MM population from VTE. In this brief perspective, we highlight some of the greatest challenges that have hampered the field concerning the availability of high-quality clinical trial data for the formulation of best VTE prophylaxis strategies in patients with newly diagnosed MM, as well as the rationale for the latest updates in the NCCN Guidelines on this topic.
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U2 - 10.6004/jnccn.2021.7112
DO - 10.6004/jnccn.2021.7112
M3 - Review article
C2 - 34991076
AN - SCOPUS:85123268180
SN - 1540-1405
VL - 20
SP - 91
EP - 95
JO - JNCCN Journal of the National Comprehensive Cancer Network
JF - JNCCN Journal of the National Comprehensive Cancer Network
IS - 1
ER -