Leclerc V, Karlin L, Herledan C, Marchal L, Baudouin A, Gouraud A, Caffin A G, Larbre V, Lazareth A, Bachy E, Salles G, Ghesquières H, Rioufol C, Ranchon F
Clinical Oncology Pharmacy Department, Hospices Civils de Lyon, Groupement Hospitalier Sud, 165 Chemin du Grand Revoyet, 69495 Pierre Bénite cedex, Pierre-Bénite, France.
Université Lyon 1, CICLY Centre Pour L'Innovation en Cancérologie de Lyon , EA 3738 , 69921, Lyon, Oullins cedex, France.
J Cancer Res Clin Oncol. 2022 Apr;148(4):975-984. doi: 10.1007/s00432-021-03693-5. Epub 2021 Jun 18.
The aim of this study is to assess international guidelines implementation concerning thromboprophylaxis strategy in myeloma patients treated with immunomodulatory drugs.
This retrospective study includes multiple myeloma patients treated with immunomodulatory drugs between 2014 and 2017 in the Hematology department of a teaching hospital (Hospices Civils de Lyon, France) and followed by the multidisciplinary care plan for cancer outpatients ONCORAL (ONCological care for outpatients with ORAL anticancer drugs). Data from immunomodulatory drugs administration, thromboprophylaxis strategy and thrombotic events were collected from medical files. Adherence to 2010 International Myeloma Working Group (IMWG) guidelines was assessed.
213 patients received at least one immunomodulatory drug: lenalidomide (60.9%), pomalidomide (24.0%) and thalidomide (15.1%). About two third of treatment lines (66.2%) were in accordance with IMWG recommendations. Among the others, 30.5% and 69.5% had thromboprophylaxis, respectively, superior or inferior to IMWG recommendations. 37 venous thrombotic events and 4 arterial thromboembolisms (one patient experienced both a stroke and deep venous thrombosis simultaneously) were reported.
Thromboprophylaxis was systematically performed in myeloma patients treated with immunomodulatory drugs in this real-life retrospective cohort. However, the choice of anticoagulant or anti-platelet agent remains debatable, as adherence to existing guidelines was variable.
本研究旨在评估关于接受免疫调节药物治疗的骨髓瘤患者血栓预防策略的国际指南的实施情况。
这项回顾性研究纳入了2014年至2017年期间在一家教学医院（法国里昂公民医院）血液科接受免疫调节药物治疗并遵循针对癌症门诊患者的多学科护理计划ONCORAL（口服抗癌药物门诊患者的肿瘤护理）的多发性骨髓瘤患者。从医疗档案中收集免疫调节药物给药、血栓预防策略和血栓事件的数据。评估对2010年国际骨髓瘤工作组（IMWG）指南的依从性。
213名患者接受了至少一种免疫调节药物：来那度胺（60.9%）、泊马度胺（24.0%）和沙利度胺（15.1%）。约三分之二的治疗疗程（66.2%）符合IMWG的建议。在其他疗程中，分别有30.5%和69.5%的疗程采取的血栓预防措施优于或劣于IMWG的建议。报告了37例静脉血栓事件和4例动脉血栓栓塞（1例患者同时发生了中风和深静脉血栓形成）。
在这个真实生活的回顾性队列中，接受免疫调节药物治疗的骨髓瘤患者系统性地进行了血栓预防。然而，由于对现有指南的依从性存在差异，抗凝剂或抗血小板药物的选择仍存在争议。
