Department of Hematology, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China.
Department of Hematology, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China.
Thromb Res. 2024 Apr;236:130-135. doi: 10.1016/j.thromres.2024.02.011. Epub 2024 Feb 15.
Multiple myeloma (MM) significantly increases the risk of venous thromboembolism (VTE) within 6 months of treatment initiation. The IMPEDE VTE score is a VTE risk prediction model which is recently incorporated into the National Comprehensive Cancer Network (NCCN) guidelines, but it lacks validation among Asians, including Chinese MM patients. We performed a retrospective chart review of 405 Chinese with newly diagnosed MM who started therapy at Beijing Jishuitan Hospital between April 2013 to October 2022. The 6-month cumulative incidence of VTE was 3.8 % (95 % CI:1.6-7.6), 8.6 % (95 % CI: 5.3-21.9) and 40.5 % (95 % CI: 24.9-55.7) in the low-, intermediate- and high-risk groups (P < 0.001), respectively. The C-statistic of the IMPEDE VTE scores for predicting VTE within 6 months of treatment initiation was 0.74 (95 % CI: 0.65-0.83). Of note, in this single-center cohort study, we propose that the anticoagulant LMWH may be more effective than the antiplatelet aspirin in potentially preventing VTE in newly diagnosed MM patients. Our findings suggest that the IMPEDE VTE score is a valid evidence-based risk stratification tool in Chinese patients with newly diagnosed MM.
多发性骨髓瘤(MM)在治疗开始后 6 个月内显著增加静脉血栓栓塞(VTE)的风险。IMPEDE VTE 评分是一种 VTE 风险预测模型,最近已纳入国家综合癌症网络(NCCN)指南,但在亚洲人群中,包括中国 MM 患者,该模型尚未得到验证。我们对 2013 年 4 月至 2022 年 10 月在北京积水潭医院接受治疗的 405 例新发 MM 中国患者进行了回顾性图表审查。低危、中危和高危组患者治疗开始后 6 个月内 VTE 的累积发生率分别为 3.8%(95%CI:1.6-7.6)、8.6%(95%CI:5.3-21.9)和 40.5%(95%CI:24.9-55.7)(P<0.001)。IMPEDE VTE 评分预测治疗开始后 6 个月内 VTE 的 C 统计量为 0.74(95%CI:0.65-0.83)。值得注意的是,在这项单中心队列研究中,我们提出抗凝低分子肝素(LMWH)可能比抗血小板药物阿司匹林更有效,从而潜在预防新发 MM 患者的 VTE。我们的研究结果表明,IMPEDE VTE 评分是一种在中国新诊断 MM 患者中有效的基于证据的风险分层工具。