title: Prospective evaluation of low-dose warfarin for prevention of thalidomide associated venous thromboembolism.
abstract: Venous thromboemobolism (VTE) is an important complication of thalidomide therapy especially when it is combined with steroids or chemotherapy. Currently there is no consensus on the most appropriate prophylactic approach. We prospectively investigated the use of low-dose warfarin sodium in prevention of thalidomide-associated VTE in patients receiving thalidomide-based combination therapies. Patients with multiple myeloma or chronic lymphocytic leukemia who were treated on thalidomide based-combination therapies were treated on low-dose warfarin (1 or 2 mg) continuously through the duration of their therapy. Among the 68 patients enrolled, four developed an episode of VTE, an overall incidence of 5.9% (odds = 0.063). Median duration of thalidomide therapy was 4 months. Low-does warfarin decreases the incidence of VTE compared to historical control and is an effective mechanism of prevention of VTE in thalidomide-based chemotherapy regimens.
authors.affiliation: Department of Medicine Roswell Park Cancer Institute, Buffalo, NY 14263, USA.
authors.forename: Kena C
authors.initials: KC
authors.lastname: Miller
authors.forename: Swaminathan
authors.initials: S
authors.lastname: Padmanabhan
authors.forename: Laurie
authors.initials: L
authors.lastname: Dimicelli
authors.forename: Dawn
authors.initials: D
authors.lastname: Depaolo
authors.forename: Beverly
authors.initials: B
authors.lastname: Landrigan
authors.forename: Jihnhee
authors.initials: J
authors.lastname: Yu
authors.forename: Virginia
authors.initials: V
authors.lastname: Doran
authors.forename: Patricia
authors.initials: P
authors.lastname: Marshal
authors.forename: Asher
authors.initials: A
authors.lastname: Chanan-Khan
mesh_terms: D000368:Aged; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy / Q000473:pathology; D013792:Thalidomide / Q000009:adverse effects* / Q000627:therapeutic use; D020246:Venous Thrombosis / Q000473:pathology / Q000517:prevention & control*; D014859:Warfarin / Q000494:pharmacology*
chemical_list: D013792:Thalidomide; D014859:Warfarin