Prevention of thalidomide- and lenalidomide-associated thrombosis in myeloma

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Prevention of thalidomide- and lenalidomide-associated thrombosis in myeloma. / Palumbo, A.; Rajkumar, S. V.; Dimopoulos, M. A.; Richardson, P. G.; Miguel, J. San; Barlogie, B.; Harousseau, J.; Zonder, J. A.; Cavo, M.; Zangari, M.; Attal, M.; Belch, A.; Knop, S.; Joshua, D.; Sezer, O.; Ludwig, H.; Vesole, D.; Blade, J.; Kyle, R.; Westin, Jan; Weber, D.; Bringhen, S.; Niesvizky, R.; Waage, A.; von Lilienfeld-Toal, M.; Lonial, S.; Morgan, G. J.; Orlowski, R. Z.; Shimizu, K.; Anderson, K. C.; Boccadoro, M.; Durie, B. G.; Sonneveld, P.; Hussein, M. A.

In: Leukemia, Vol. 22, No. 2, 2008, p. 414-423.

Research output: Contribution to journalArticle

Harvard

Palumbo, A, Rajkumar, SV, Dimopoulos, MA, Richardson, PG, Miguel, JS, Barlogie, B, Harousseau, J, Zonder, JA, Cavo, M, Zangari, M, Attal, M, Belch, A, Knop, S, Joshua, D, Sezer, O, Ludwig, H, Vesole, D, Blade, J, Kyle, R, Westin, J, Weber, D, Bringhen, S, Niesvizky, R, Waage, A, von Lilienfeld-Toal, M, Lonial, S, Morgan, GJ, Orlowski, RZ, Shimizu, K, Anderson, KC, Boccadoro, M, Durie, BG, Sonneveld, P & Hussein, MA 2008, 'Prevention of thalidomide- and lenalidomide-associated thrombosis in myeloma', Leukemia, vol. 22, no. 2, pp. 414-423. https://doi.org/10.1038/sj.leu.2405062

APA

Palumbo, A., Rajkumar, S. V., Dimopoulos, M. A., Richardson, P. G., Miguel, J. S., Barlogie, B., ... Hussein, M. A. (2008). Prevention of thalidomide- and lenalidomide-associated thrombosis in myeloma. Leukemia, 22(2), 414-423. https://doi.org/10.1038/sj.leu.2405062

CBE

Palumbo A, Rajkumar SV, Dimopoulos MA, Richardson PG, Miguel JS, Barlogie B, Harousseau J, Zonder JA, Cavo M, Zangari M, Attal M, Belch A, Knop S, Joshua D, Sezer O, Ludwig H, Vesole D, Blade J, Kyle R, Westin J, Weber D, Bringhen S, Niesvizky R, Waage A, von Lilienfeld-Toal M, Lonial S, Morgan GJ, Orlowski RZ, Shimizu K, Anderson KC, Boccadoro M, Durie BG, Sonneveld P, Hussein MA. 2008. Prevention of thalidomide- and lenalidomide-associated thrombosis in myeloma. Leukemia. 22(2):414-423. https://doi.org/10.1038/sj.leu.2405062

MLA

Vancouver

Palumbo A, Rajkumar SV, Dimopoulos MA, Richardson PG, Miguel JS, Barlogie B et al. Prevention of thalidomide- and lenalidomide-associated thrombosis in myeloma. Leukemia. 2008;22(2):414-423. https://doi.org/10.1038/sj.leu.2405062

Author

Palumbo, A. ; Rajkumar, S. V. ; Dimopoulos, M. A. ; Richardson, P. G. ; Miguel, J. San ; Barlogie, B. ; Harousseau, J. ; Zonder, J. A. ; Cavo, M. ; Zangari, M. ; Attal, M. ; Belch, A. ; Knop, S. ; Joshua, D. ; Sezer, O. ; Ludwig, H. ; Vesole, D. ; Blade, J. ; Kyle, R. ; Westin, Jan ; Weber, D. ; Bringhen, S. ; Niesvizky, R. ; Waage, A. ; von Lilienfeld-Toal, M. ; Lonial, S. ; Morgan, G. J. ; Orlowski, R. Z. ; Shimizu, K. ; Anderson, K. C. ; Boccadoro, M. ; Durie, B. G. ; Sonneveld, P. ; Hussein, M. A. / Prevention of thalidomide- and lenalidomide-associated thrombosis in myeloma. In: Leukemia. 2008 ; Vol. 22, No. 2. pp. 414-423.

RIS

TY - JOUR

T1 - Prevention of thalidomide- and lenalidomide-associated thrombosis in myeloma

AU - Palumbo, A.

AU - Rajkumar, S. V.

AU - Dimopoulos, M. A.

AU - Richardson, P. G.

AU - Miguel, J. San

AU - Barlogie, B.

AU - Harousseau, J.

AU - Zonder, J. A.

AU - Cavo, M.

AU - Zangari, M.

AU - Attal, M.

AU - Belch, A.

AU - Knop, S.

AU - Joshua, D.

AU - Sezer, O.

AU - Ludwig, H.

AU - Vesole, D.

AU - Blade, J.

AU - Kyle, R.

AU - Westin, Jan

AU - Weber, D.

AU - Bringhen, S.

AU - Niesvizky, R.

AU - Waage, A.

AU - von Lilienfeld-Toal, M.

AU - Lonial, S.

AU - Morgan, G. J.

AU - Orlowski, R. Z.

AU - Shimizu, K.

AU - Anderson, K. C.

AU - Boccadoro, M.

AU - Durie, B. G.

AU - Sonneveld, P.

AU - Hussein, M. A.

PY - 2008

Y1 - 2008

N2 - The incidence of venous thromboembolism (VTE) is more than 1%omicron annually in the general population and increases further in cancer patients. The risk of VTE is higher in multiple myeloma (MM) patients who receive thalidomide or lenalidomide, especially in combination with dexamethasone or chemotherapy. Various VTE prophylaxis strategies, such as low-molecular-Weight heparin (LMWH), warfarin or aspirin, have been investigated in small, uncontrolled clinical studies. This manuscript summarizes the available evidence and recommends a prophylaxis strategy according to a risk-assessment model. Individual risk factors for thrombosis associated with thalidomide/lenalidomide-based therapy include age, history of VTE, central venous catheter, comorbidities (infections, diabetes, cardiac disease), immobilization, surgery and inherited thrombophilia. Myeloma-related risk factors include diagnosis and hyperviscosity. VTE is very high in patients who receive high-dose dexamethasone, doxorubicin or multiagent chemotherapy in combination with thalidomide or lenalidomide, but not with bortezomib. The panel recommends aspirin for patients with <= 1 risk factor for VTE. LMWH (equivalent to enoxaparin 40 mg per day) is recommended for those with two or more individual/myeloma-related risk factors. LMWH is also recommended for all patients receiving concurrent high-dose dexamethasone or doxorubicin. Full-dose warfarin targeting a therapeutic INR of 2-3 is an alternative to LMWH, although there are limited data in the literature with this strategy. In the absence of clear data from randomized studies as a foundation for recommendations, many of the following proposed strategies are the results of common sense or derive from the extrapolation of data from many studies not specifically designed to answer these questions. Further investigation is needed to define the best VTE prophylaxis.

AB - The incidence of venous thromboembolism (VTE) is more than 1%omicron annually in the general population and increases further in cancer patients. The risk of VTE is higher in multiple myeloma (MM) patients who receive thalidomide or lenalidomide, especially in combination with dexamethasone or chemotherapy. Various VTE prophylaxis strategies, such as low-molecular-Weight heparin (LMWH), warfarin or aspirin, have been investigated in small, uncontrolled clinical studies. This manuscript summarizes the available evidence and recommends a prophylaxis strategy according to a risk-assessment model. Individual risk factors for thrombosis associated with thalidomide/lenalidomide-based therapy include age, history of VTE, central venous catheter, comorbidities (infections, diabetes, cardiac disease), immobilization, surgery and inherited thrombophilia. Myeloma-related risk factors include diagnosis and hyperviscosity. VTE is very high in patients who receive high-dose dexamethasone, doxorubicin or multiagent chemotherapy in combination with thalidomide or lenalidomide, but not with bortezomib. The panel recommends aspirin for patients with <= 1 risk factor for VTE. LMWH (equivalent to enoxaparin 40 mg per day) is recommended for those with two or more individual/myeloma-related risk factors. LMWH is also recommended for all patients receiving concurrent high-dose dexamethasone or doxorubicin. Full-dose warfarin targeting a therapeutic INR of 2-3 is an alternative to LMWH, although there are limited data in the literature with this strategy. In the absence of clear data from randomized studies as a foundation for recommendations, many of the following proposed strategies are the results of common sense or derive from the extrapolation of data from many studies not specifically designed to answer these questions. Further investigation is needed to define the best VTE prophylaxis.

KW - lenalidomide

KW - thalidomide

KW - risk factors

KW - thrombosis

KW - prophylaxis

U2 - 10.1038/sj.leu.2405062

DO - 10.1038/sj.leu.2405062

M3 - Article

VL - 22

SP - 414

EP - 423

JO - Leukemia : official journal of the Leukemia Society of America, Leukemia Research Fund, U.K

JF - Leukemia : official journal of the Leukemia Society of America, Leukemia Research Fund, U.K

SN - 1476-5551

IS - 2

ER -