Department of Pharmacy, Sylvester Comprehensive Cancer Center, University of Miami Hospitals and Clinics, Miami, FL, USA.
Department of Pharmacy, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Br J Haematol. 2022 Jan;196(1):105-109. doi: 10.1111/bjh.17772. Epub 2021 Aug 15.
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.
新诊断多发性骨髓瘤(NDMM)患者的不同治疗方案静脉血栓栓塞症(VTE)的发生率有所不同。在血液系统恶性肿瘤,特别是多发性骨髓瘤患者中,关于使用直接口服抗凝剂进行血栓预防的相关数据有限。在这项对 305 例 NDMM 患者的回顾性研究中,接受卡非佐米、来那度胺、地塞米松(KRD)+阿司匹林(ASA)、硼替佐米、来那度胺、地塞米松(RVD)+ASA 和 KRD+利伐沙班治疗的患者 VTE 发生率分别为 16.1%、4.8%和 4.8%,具有统计学意义。研究结果证实,与 RVD 诱导相比,使用 KRD 诱导时 VTE 的发生率更高,并且表明使用低剂量利伐沙班进行血栓预防可以降低这种风险,而不会增加出血风险。