title: Thrombosis in multiple myeloma (MM).
abstract: Thrombosis is a frequent feature in individuals with myeloma, particularly those treated with oral immunomodulatory drugs (IMID) such as thalidomide or lenalidomide concomitantly with anthracyclines or dexamethasone. Up to a third of these individuals may develop  venous thrombosis if not given the benefit of prophylaxis. Interestingly, in contrast to individuals with solid tumors in whom thrombosis is a marker of poor prognosis, thrombosis does not impact overall survival in patients with myeloma. This finding suggests that the mechanisms of thrombosis  in hematological neoplasms may differ from solid epithelial tumors and that thrombosis in the former may be driven by therapy and not by a procoagulant phenotype of the neoplastic plasma cells. This may also explain why thrombosis in the context of IMID-based therapy may be prevented by the  use of prophylactic aspirin. In this text, we review the pathogenesis of thrombosis in myeloma, its relation to different chemotherapeutic regimens and the use of thrombo-prophylaxis.
authors.affiliation: Instituto Nacional de Cancerología, Mexico City, DF, México. gcesarman@gmail.com
authors.forename: Gabriela
authors.initials: G
authors.lastname: Cesarman-Maus
authors.forename: Esteban
authors.initials: E
authors.lastname: Braggio
authors.forename: Rafael
authors.initials: R
authors.lastname: Fonseca
mesh_terms: D018943:Anthracyclines / Q000009:adverse effects; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects; D003907:Dexamethasone / Q000009:adverse effects; D006801:Humans; D007155:Immunologic Factors / Q000009:adverse effects*; D000077269:Lenalidomide; D009101:Multiple Myeloma / Q000150:complications* / Q000188:drug therapy; D061988:Proteasome Inhibitors; D013792:Thalidomide / Q000009:adverse effects* / Q000031:analogs & derivatives*; D013927:Thrombosis / Q000139:chemically induced* / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*
chemical_list: D018943:Anthracyclines; D018931:Antineoplastic Agents, Hormonal; D007155:Immunologic Factors; D061988:Proteasome Inhibitors; D013792:Thalidomide; D003907:Dexamethasone; D000077269:Lenalidomide