Comparison of venous thromboembolism incidence in newly diagnosed multiple myeloma patients receiving bortezomib, lenalidomide, dexamethasone (RVD) or carfilzomib, lenalidomide, dexamethasone (KRD) with aspirin or rivaroxaban thromboprophylaxis

Br J Haematol. 2022 Jan;196(1):105-109. doi: 10.1111/bjh.17772. Epub 2021 Aug 15.

Abstract

Incidence of venous thromboembolism (VTE) varies across different regimens in newly diagnosed multiple myeloma (NDMM) patients. Limited data exist on the use of direct oral anticoagulants as thromboprophylaxis in the setting of haematologic malignancies, specifically multiple myeloma. In this retrospective study of 305 NDMM patients, VTE rates in those treated with carfilzomib, lenalidomide, dexamethasone (KRD) + aspirin (ASA), bortezomib, lenalidomide, dexamethasone (RVD) + ASA, and KRD + rivaroxaban were statistically significant, 16·1%, 4·8%, and 4·8%, respectively. The findings confirm a higher incidence of VTE when using KRD induction compared to RVD induction and reveal that the use of low-dose rivaroxaban thromboprophylaxis can mitigate this risk without an observable increase in bleeding rates.

Keywords: anticoagulation; haematological oncology; multiple myeloma; myeloma therapy; thrombosis.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Aspirin / administration & dosage
  • Bortezomib / administration & dosage
  • Dexamethasone / administration & dosage
  • Disease Management
  • Disease Susceptibility
  • Female
  • Humans
  • Incidence
  • Lenalidomide / administration & dosage
  • Male
  • Middle Aged
  • Multiple Myeloma / complications*
  • Multiple Myeloma / diagnosis
  • Multiple Myeloma / drug therapy*
  • Neoplasm Grading
  • Neoplasm Staging
  • Oligopeptides / administration & dosage
  • Retrospective Studies
  • Venous Thromboembolism / diagnosis
  • Venous Thromboembolism / epidemiology*
  • Venous Thromboembolism / etiology*

Substances

  • Oligopeptides
  • Bortezomib
  • carfilzomib
  • Dexamethasone
  • Lenalidomide
  • Aspirin