Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Ann Med. 2023;55(2):2263019. doi: 10.1080/07853890.2023.2263019. Epub 2023 Nov 20.
Venous thromboembolism (VTE) is one of the most common and severe complications of multiple myeloma (MM). The aim of this study was to learn about the current awareness regarding MM-associated VTE among Chinese hematologists.
A nationwide, online, questionnaire-based survey was sent to the specialized hematologists in mainland China. The questionnaire investigated respondents' demographic and occupational characteristics, their ability to identify VTE risk factors, and their thromboprophylaxis decisions for different anti-MM regimens. Six clinical vignettes were used to evaluate hematologists' awareness of stratified thromboprophylaxis. The data were analyzed using SPSS software.
A total of 518 valid questionnaires were received. Of the 518 hematologists investigated, only 23.7% of them could identify VTE-related risk factors correctly. Most hematologists could select appropriate thromboprophylaxis for common anti-MM regimens such as VCd (bortezomib, cyclophosphamide, and dexamethasone) and VRd (bortezomib, lenalidomide, and dexamethasone), but not for uncommon ones such as VTD-PACE (bortezomib, thalidomide, dexamethasone, cisplatin, doxorubicin, cyclophosphamide, and etoposide) and KRd (carfilzomib, lenalidomide, and dexamethasone). The results from the vignettes suggested that only 19.5% of the hematologists could be defined as the 'stratified thromboprophylaxis' group, and the awareness of stratified thromboprophylaxis depended significantly on physicians' age and working seniority.
The results of our study showed that a large proportion of Chinese hematologists failed to recognize the VTE risk factors, most of them cannot select appropriate thromboprophylaxis for different MM therapeutic regimens and lack awareness of stratified thromboprophylaxis for MM-associated VTE. A standard VTE prevention guideline is urgently needed for the Chinese myeloma group. Continuous education for new professionals should be encouraged. A VTE collaborative group is supposed to be established in each hospital to enhance the overall medical care for VTE patients.
静脉血栓栓塞症（VTE）是多发性骨髓瘤（MM）最常见且最严重的并发症之一。本研究旨在了解中国血液科医生对 MM 相关 VTE 的认知现状。
我们对中国大陆的血液科医生进行了一项全国性的、在线的、基于问卷的调查。该问卷调查了受访者的人口统计学和职业特征、他们识别 VTE 危险因素的能力，以及他们对不同抗 MM 方案的血栓预防决策。使用 6 个临床病例来评估血液科医生对分层血栓预防的认识。数据使用 SPSS 软件进行分析。
共收到 518 份有效问卷。在接受调查的 518 名血液科医生中，只有 23.7%的人能够正确识别 VTE 相关的危险因素。大多数血液科医生能够为常见的抗 MM 方案（如 VCd[硼替佐米、环磷酰胺和地塞米松]和 VRd[硼替佐米、来那度胺和地塞米松]）选择合适的血栓预防措施，但不能为不常见的方案（如 VTD-PACE[硼替佐米、沙利度胺、地塞米松、顺铂、阿霉素、环磷酰胺和依托泊苷]和 KRd[卡非佐米、来那度胺和地塞米松]）选择合适的血栓预防措施。病例分析的结果表明，只有 19.5%的血液科医生可以被定义为“分层血栓预防”组，分层血栓预防的意识显著取决于医生的年龄和工作年限。
我们的研究结果表明，很大一部分中国血液科医生未能识别 VTE 的危险因素，他们中的大多数人不能为不同的 MM 治疗方案选择合适的血栓预防措施，也缺乏对 MM 相关 VTE 的分层血栓预防意识。中国骨髓瘤患者群体急需制定标准的 VTE 预防指南。应鼓励为新专业人员提供持续教育。应在每家医院设立一个 VTE 协作组，以提高 VTE 患者的整体医疗水平。
