Hypercoagulable states in patients with multiple myeloma can affect the thalidomide-associated venous thromboembolism.
The therapeutic use of thalidomide in patients with multiple myeloma is often complicated by the development of venous thromboembolism. The objective of the present study was to identify hypercoagulable states associated with development of venous thromboembolism in thalidomide-treated multiple myeloma patients. We screened 49 consecutive multiple myeloma patients treated with thalidomide at baseline for hypercoagulability. With a median follow-up of 11 months, 10 of 49 multiple myeloma patients developed a thrombotic episode. Laboratory assays revealed an underlying abnormality in nine of the 10 patients; hypercoagulable screenings were normal in 36 of the 39 patients who did not develop venous thromboembolism (P < 0.0001). Our retrospective study results suggest that the multiple myeloma patients with thromboembolic complications during treatment with thalidomide have a frequent concomitant underlying thrombophilic state.
Division of Hematology-Oncology, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA.
Giampaolo P
GP
Talamo
Sulfi
S
Ibrahim
David
D
Claxton
Guido J
GJ
Tricot
Louis M
LM
Fink
Maurizio
M
Zangari
D020016:Activated Protein C Resistance / Q000150:complications / Q000235:genetics; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D000925:Anticoagulants / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D002945:Cisplatin / Q000008:administration & dosage; D003907:Dexamethasone / Q000008:administration & dosage / Q000009:adverse effects; D004317:Doxorubicin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005165:Factor V / Q000235:genetics; D005500:Follow-Up Studies; D006801:Humans; D020138:Hyperhomocysteinemia / Q000150:complications; D009101:Multiple Myeloma / Q000097:blood* / Q000188:drug therapy; D011241:Prednisone / Q000008:administration & dosage; D011655:Pulmonary Embolism / Q000139:chemically induced* / Q000209:etiology / Q000517:prevention & control; D012189:Retrospective Studies; D013792:Thalidomide / Q000008:administration & dosage / Q000009:adverse effects*; D019851:Thrombophilia / Q000097:blood / Q000188:drug therapy / Q000209:etiology* / Q000235:genetics; D020246:Venous Thrombosis / Q000139:chemically induced* / Q000209:etiology / Q000517:prevention & control
D020533:Angiogenesis Inhibitors; D000925:Anticoagulants; C542926:DT PACE regimen; C095381:factor V Leiden; D013792:Thalidomide; D005047:Etoposide; D003907:Dexamethasone; D004317:Doxorubicin; D005165:Factor V; D002945:Cisplatin; D011241:Prednisone