Hussein Mohamad A
Multiple Myeloma Multidisciplinary Clinical Research Program, Cleveland Clinic Taussig Cancer Center, 9500 Euclid Ave, Ohio 44195, USA.
Thromb Haemost. 2006 Jun;95(6):924-30. doi: 10.1160/TH06-02-0080.
Deep vein thrombosis and its lethal complication pulmonary embolism are manifestations of venous thromboembolism (VTE), which is typically associated with cancer and recent major surgery. Certain solid tumors and hematologic malignancies impose an inherently elevated risk of VTE that is compounded by chemotherapy and other risk factors. Multiple myeloma (MM) and other plasma cell dyscrasias are thrombogenic as a consequence of their multiple hemostatic effects, including elevated interleukin-6 levels, pro-coagulant antibody formation, paraprotein interference with fibrin structure, activated protein C resistance, and endothelial damage. The oral immunomodulatory drugs thalidomide and lenalidomide have produced major therapeutic responses in patients with MM when used in combination with oral steroids and chemotherapy, but a high incidence of VTE has been reported. Various VTE prophylaxis strategies with thalidomide- and lenalidomide-containing combinations have been investigated in clinical studies. This review discusses emerging results on the use of VTE prophylaxis to minimize VTE risks associated with MM treatment regimens containing thalidomide and lenalidomide.
深静脉血栓形成及其致命并发症肺栓塞是静脉血栓栓塞症（VTE）的表现，VTE通常与癌症和近期大手术相关。某些实体瘤和血液系统恶性肿瘤本身就会增加VTE风险，化疗和其他风险因素会使这种风险进一步加剧。多发性骨髓瘤（MM）和其他浆细胞发育异常由于其多种止血作用而具有血栓形成倾向，这些作用包括白细胞介素-6水平升高、促凝抗体形成、副蛋白干扰纤维蛋白结构、活化蛋白C抵抗和内皮损伤。口服免疫调节药物沙利度胺和来那度胺与口服类固醇和化疗联合使用时，已在MM患者中产生了主要治疗反应，但据报道VTE发生率很高。临床研究中已对含沙利度胺和来那度胺组合的各种VTE预防策略进行了研究。本综述讨论了使用VTE预防措施以尽量降低与含沙利度胺和来那度胺的MM治疗方案相关的VTE风险的新出现结果。
