Prevention of venous thromboembolism with low molecular-weight heparin in patients with multiple myeloma treated with thalidomide and chemotherapy

Minnema, Monique C.; Breitkreutz, Iris; Auwerda, J. J. A.; Holt, Bronno van der; Cremer, Friedrich W.; Marion, Ariënne M W van; Westveer, Petra H. M.; Sonneveld, Pieter; Goldschmidt, Hartmut; Lokhorst, Henk M.

doi:10.1038/sj.leu.2403533

Cited by 99 publications

(58 citation statements)

References 8 publications

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“…In TAD-treated patients, peripheral polyneuropathy, general constitutional symptoms as well as impaired gastrointestinal function such as constipation were observed (Table 3), similar to other groups. 24 The incidence of deep vein thrombosis occurred in HOVON-50/GMMG-HD3 patients after treatment with VAD or TAD was currently Table 2 Literature regarding thalidomide administration and following peripheral blood stem cell collection in MM patients 25 and showed that LMWH effectively reduced thalidomide-associated venous thromboembolism (VTE).…”

Section: Response Rate and Treatment Related Toxicities Before Pbscmentioning

confidence: 99%

Thalidomide in newly diagnosed multiple myeloma: influence of thalidomide treatment on peripheral blood stem cell collection yield

et al. 2007

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In a phase III randomized, multicenter study, the Germanspeaking Myeloma-Multicenter Group (GMMG) and the DutchBelgian Hemato-Oncology Cooperative Group (HOVON) group investigated the influence of thalidomide (Thal) on the outcome of peripheral blood stem cell (PBSC) collection in multiple myeloma (MM) before peripheral autologous blood stem cell transplantation (ABSCT). We analyzed the data of 398 myeloma patients after induction with Thal, doxorubicin and dexamethasone (TAD) in comparison with vincristine, doxorubicin and dexamethasone (VAD) followed by mobilization with cyclophosphamide, doxorubicin, dexamethasone (CAD) and PBSC collection. Within both the study groups, patients treated with TAD showed to collect significantly fewer CD34 þ cells compared with VAD (GMMG, TAD: median 9.8 Â 10 6 /kg; range 2.0-33.6; VAD: median 10.9 Â 10 6 /kg range 3.0-36.0; P ¼ 0.02) (HOVON, TAD: median 7.4 Â 10 6 /kg; range 2.0-33.0; VAD: median 9.4 Â 10 6 /kg; range 0.0-48.7; P ¼ 0.009). However, engraftment after peripheral autologous stem cell transplantation showed no difference between Thal and VAD groups. We conclude that Thal as a part of induction regimen is associated with better response rates (GMMG-HD3: CR/PR 79%, VAD: CR/PR 58%; HOVON-50: TAD: CR/PR 81%, VAD: CR/PR 61%), but significantly affects the yield of PBSC collection. Nevertheless, the number of total CD34 þ cells collected was sufficient for double autologous transplantation in 82% of the Thal patients, with at least 2.5 Â 10 6 /kg CD34 þ cells.

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Section: Response Rate and Treatment Related Toxicities Before Pbscmentioning

confidence: 99%

Thalidomide in newly diagnosed multiple myeloma: influence of thalidomide treatment on peripheral blood stem cell collection yield

et al. 2007

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“…Currently, there are only recommendations on thromboprophylaxis for multiple myeloma patients who are treated with thalidomide-or lenalidomide-containing regimens [10]. In these patients, thromboprophylaxis with low molecular weight heparin (LMWH) is effective in reducing thrombotic complications [9]. Several studies have shown that aspirin is also effective in reducing thrombotic events [10].…”

Section: Discussionmentioning

confidence: 99%

“…Whether thromboprophylaxis will also reduce the risk of arterial thrombotic complications is unknown; however, this complication is only rarely observed and predominantly reported in patients treated with thalidomide [8]. Based on the recent reports of the frequency of venous thrombotic complications and the occurrence, although rare, of arterial thrombotic complications in multiple myeloma patients receiving induction chemotherapy not containing thalidomide or lenalidomide, giving thromboprophylaxis with aspirin also to these individuals [3,9]. Our patient's medical history was positive for cardiovascular disease.…”

Section: Discussionmentioning

confidence: 99%

Treatment of multiple myeloma and arterial thrombosis

Raven¹,

Berghout²,

Houten³

et al. 2009

Ann Hematol

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“…At the start of this study, there were no guidelines on use of thrombosis prophylaxis. Low molecular weight heparin was recommended as standard during MPT treatment from 2005 on, and during maintenance, low-dose aspirin was advised [9,11]. The study was conducted according to the Declaration of Helsinki and the guidelines of good clinical practice.…”

Section: Study Design and Treatmentmentioning

confidence: 99%

Effect of thalidomide with melphalan and prednisone on health-related quality of life (HRQoL) in elderly patients with newly diagnosed multiple myeloma: a prospective analysis in a randomized trial

et al. 2011

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Thalidomide with melphalan/prednisone (MPT) was defined as standard treatment in elderly patients with multiple myeloma (MM) based on five randomized trials. In one of these trials, HOVON49, a prospective health-related quality-of-life (HRQoL) study was initiated in order to assess the impact of thalidomide on QoL. Patients aged >65 years with newly diagnosed MM were randomized to receive melphalan plus prednisone (MP) or MPT, followed by thalidomide maintenance in the MPT arm. Two hundred eighty-four patients were included in this side study (MP, n= 149; MPT n=135). HRQoL was assessed with the EORTC Core QoL Questionnaire (QLQ-C30) and the myelomaspecific module (QLQ-MY24) at baseline and at predetermined intervals during treatment. The QLQ-C30 subscales physical function (P=0.044) and constipation (P<0.001) showed an improvement during induction in favour of the

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Prevention of venous thromboembolism with low molecular-weight heparin in patients with multiple myeloma treated with thalidomide and chemotherapy

Cited by 99 publications

References 8 publications

Thalidomide in newly diagnosed multiple myeloma: influence of thalidomide treatment on peripheral blood stem cell collection yield

Thalidomide in newly diagnosed multiple myeloma: influence of thalidomide treatment on peripheral blood stem cell collection yield

Treatment of multiple myeloma and arterial thrombosis

Effect of thalidomide with melphalan and prednisone on health-related quality of life (HRQoL) in elderly patients with newly diagnosed multiple myeloma: a prospective analysis in a randomized trial

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