title: Thromboprophylaxis in myeloma: what is happening outside of clinical trials?
abstract: Patients with myeloma are at high risk of venous thromboembolism (VTE). There is no consensus about what agent to use or what haematologists are doing in clinical practice. A survey was sent to haematologists treating patients with myeloma in Ireland. 32/45 (71%) responded. 13/28 (46%) felt that VTE affected < 5% of patients. However, 8/28 (29%) felt it affected 10-19%. Thromboprophylaxis was most commonly used in patients on lenalidomide; 25/28 (89%) and thalidomide; 23/28 (82%). 23/28 (82%) used LMWH and 20/28 (71%) used aspirin either very frequently or frequently. 3/28 (11%) had used dabigatran/rivaroxaban despite there being little evidence to support their use. Efficacy was the most important factor in choosing an agent for 25/28 (89%). Bleeding was not felt to be an issue 15/29 (52%) were not using thromboprophylaxis guidelines. This survey demonstrated wide variation in the beliefs and practices regarding the burden of VTE in patients with myeloma and the need for thromboprophylaxis.
authors.forename: M P
authors.initials: MP
authors.lastname: Crowley
authors.forename: B
authors.initials: B
authors.lastname: Kevane
authors.forename: J A
authors.initials: JA
authors.lastname: Eustace
authors.forename: S
authors.initials: S
authors.lastname: O'Shea
authors.forename: O
authors.initials: O
authors.lastname: Gilligan
mesh_terms: D001291:Attitude of Health Personnel; D019538:Health Care Surveys; D006401:Hematologic Agents / Q000145:classification / Q000627:therapeutic use; D006405:Hematology / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D007494:Ireland; D009101:Multiple Myeloma / Q000150:complications*; D010358:Patient Participation; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000706:statistics & numerical data; D011314:Preventive Health Services / Q000379:methods / Q000592:standards; D018570:Risk Assessment; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000209:etiology / Q000517:prevention & control / Q000523:psychology
chemical_list: D006401:Hematologic Agents