Myeloma Patients Not Receiving Guideline-recommended Thromboprophylaxis
Data suggest that most patients with MM taking immunomodulatory therapy are not receiving appropriate thromboprophylaxis.
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Most patients with multiple myeloma (MM) taking immunomodulatory therapy are not receiving guideline-recommended thromboprophylaxis, according to a poster presented at the 2017 Hematology/Oncology Pharmacy Association Annual Conference.1
Patients with MM taking immunomodulatory agents are at an increased risk of developing venous thromboembolism (VTE). The National Comprehensive Cancer Network (NCCN) and American Society of Clinical Oncology (ASCO) recommend thromboprophylaxis, but it is unknown if these strategies have been adopted. The purpose of this study was to determine if NCCN and ASCO recommendations are followed, and the rate of VTE with guideline-based care.
This retrospective chart review included 107 patients with MM who developed VTE during immunomodulating therapy from the Dana-Farber Cancer Institute/Brigham and Women's Cancer Center. Most patients were treated with lenalidomide (79%), followed by thalidomide (15%) and pomalidomide (6%).
The median number of VTE risk factors was 3 (range, 1-6), with 88.8% of patients harboring at least 2 risk factors.
In this population, 83.2% of patients did not receive guideline-recommended thromboprophylaxis and 15% of patients did not receive any thromboprophylaxis. Aspirin was administered in 9.4%, warfarin in 3.7%, and enoxaparin in 3.7%.
VTE occurred in 1.9% of patients who received thromboprophylaxis. VTE occurred in a median 71 days after immunomodulator initiation.
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The data from this study suggest that most patients with MM taking immunomodulatory therapy are not receiving appropriate thromboprophylaxis. The authors recommended that centers should “create a VTE risk algorithm that will allow physicians to easily identify risk factors and initiate appropriate thromboprophylaxis regimens.”
Read more of Cancer Therapy Advisor's coverage of the 2017 Hematology/Oncology Pharmacy Association (HOPA) Annual Conference by visiting the conference page.
- Smith SL, Parnes AD, Leblebjian H. Evaluation of venous thromboembolism (VTE) risk factors and thromboprophylaxis in multiple myeloma patients receiving immunomodulatory agents. Poster presented at: 13th Hematology/Oncology Pharmacy Association Annual Conference; March 29-April 1, 2017; Anaheim, CA.