title: Prophylactic low-dose aspirin is effective antithrombotic therapy for combination treatments of thalidomide or lenalidomide in myeloma.
abstract: Multiple myeloma (MM) patients have a propensity for thromboembolic events (TE), and treatment with thalidomide/dexamethasone or lenalidomide/dexamethasone increases this risk. This report describes the use of low-dose aspirin (81 mg) as primary thromboprophylaxis in three series of MM patients receiving thalidomide or lenalidomide with other drugs. In the first regimen (clarithromycin, thalidomide, dexamethasone), initiation of low-dose aspirin negated the occurrence of any further TE. In a second study, prophylactic aspirin given with thalidomide/dexamethasone resulted in a rate of TE similar to that seen with dexamethasone alone (without aspirin). A third study (n = 72) evaluated thrombosis rates with aspirin and a lenalidomide-containing regimen (clarithromycin, lenalidomide, dexamethasone). Of nine occurrences of thromboembolism, five were associated with aspirin interruption or poor compliance. Low-dose aspirin appears to reduce the incidence of thrombosis with these regimens. Routine use of aspirin as antithrombotic prophylaxis in MM patients receiving immunomodulatory drugs with corticosteroids is warranted.
authors: Center of Excellence for Lymphoma and Myeloma, Department of Medicine, Weill Medical College of Cornell University, New York, NY 10021, USA. run9001@med.cornell.edu
authors: Ruben
authors: R
authors: Niesvizky
authors: Déborah
authors: D
authors: Martínez-Baños
authors: Jessica
authors: J
authors: Jalbrzikowski
authors: Paul
authors: P
authors: Christos
authors: Jessica
authors: J
authors: Furst
authors: Maria
authors: M
authors: De Sancho
authors: Tomer
authors: T
authors: Mark
authors: Roger
authors: R
authors: Pearse
authors: Madhu
authors: M
authors: Mazumdar
authors: Faiza
authors: F
authors: Zafar
authors: Karen
authors: K
authors: Pekle
authors: John
authors: J
authors: Leonard
authors: David
authors: D
authors: Jayabalan
authors: Morton
authors: M
authors: Coleman
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001241:Aspirin / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D000077269:Lenalidomide; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy*; D012189:Retrospective Studies; D013792:Thalidomide / Q000008:administration & dosage / Q000009:adverse effects* / Q000031:analogs & derivatives*; D013927:Thrombosis / Q000517:prevention & control*
chemical_list: D000970:Antineoplastic Agents; D006495:Heparin, Low-Molecular-Weight; D013792:Thalidomide; D000077269:Lenalidomide; D001241:Aspirin