title: Clinical outcomes of venous thromboembolism with dalteparin therapy in multiple myeloma patients.
abstract: This study focused on the clinical outcomes in multiple myeloma (MM) patients with venous thromboembolism (VTE) who received low-molecular-weight heparin (dalteparin) therapy. Changes in D-dimer levels before and after VTE were also evaluated. Among 549 patients treated with various chemotherapeutic agents, a total of 52 (9.47%) patients including 32 newly diagnosed with MM and 16 with relapsed/refractory MM developed VTE, 48 of whom received dalteparin. Among the 48 treated patients, 37 (77%) had proximal deep vein thrombosis (DVT), four had (8%) pulmonary embolism (PE), and seven (15%) had both DVT and PE. In 32 patients with available paired samples (at baseline and VTE occurrence), significant conversion of D-dimer levels from 2.2 ± 0.4 mg/L to 11.8 ± 1.6 mg/L (P < 0.001) was observed, which decreased from 10.9 ± 0.4 mg/L to 1.9 ± 0.6 mg/L one month after initiating dalteparin therapy. A total of 44 patients received dalteparin with a median duration of 4.2 months (range, 2.7-9.4), and four patients were discontinued early due to death (n = 3) and major bleeding (n = 1). After a median follow-up of 9.0 months (range, 0.7-35.8) since the first VTE episode, five patients showed recurrence of VTE with a cumulative incidence of 17.5 ± 7.9%. Major bleeding occurred in three patients. In summary, dalteparin seems to be a promising drug for the treatment of VTE in MM. In addition, the significant difference in D-dimer levels observed before occurrence of VTE and after dalteparin treatment may suggest the usefulness of D-dimer testing as a surrogate marker for VTE in MM patients.
authors.affiliation: Hematology, Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Republic of Korea.
authors.forename: Sung-Eun
authors.initials: SE
authors.lastname: Lee
authors.affiliation: Hematology, Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Republic of Korea.
authors.forename: Young-Woo
authors.initials: YW
authors.lastname: Jeon
authors.affiliation: Hematology, Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Republic of Korea.
authors.forename: Jae-Ho
authors.initials: JH
authors.lastname: Yoon
authors.affiliation: Hematology, Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Republic of Korea.
authors.forename: Byung-Sik
authors.initials: BS
authors.lastname: Cho
authors.affiliation: Hematology, Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Republic of Korea.
authors.forename: Ki-Seong
authors.initials: KS
authors.lastname: Eom
authors.affiliation: Hematology, Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Republic of Korea.
authors.forename: Yoo-Jin
authors.initials: YJ
authors.lastname: Kim
authors.affiliation: Hematology, Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Republic of Korea.
authors.forename: Hee-Je
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Hematology, Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Republic of Korea.
authors.forename: Seok
authors.initials: S
authors.lastname: Lee
authors.affiliation: Hematology, Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Republic of Korea.
authors.forename: Seok-Goo
authors.initials: SG
authors.lastname: Cho
authors.affiliation: Hematology, Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Republic of Korea.
authors.forename: Dong-Wook
authors.initials: DW
authors.lastname: Kim
authors.affiliation: Hematology, Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Republic of Korea.
authors.forename: Jong Wook
authors.initials: JW
authors.lastname: Lee
authors.affiliation: Hematology, Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Republic of Korea.
authors.forename: Woo-Sung
authors.initials: WS
authors.lastname: Min
authors.affiliation: Department of Laboratory Medicine, The Catholic University of Korea, College of Medicine, Seoul, Republic of Korea.
authors.forename: Myungshin
authors.initials: M
authors.lastname: Kim
authors.affiliation: Hematology, Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Republic of Korea. Electronic address: ckmin@catholic.ac.kr.
authors.forename: Chang-Ki
authors.initials: CK
authors.lastname: Min
mesh_terms: D000328:Adult; D000368:Aged; D017985:Dalteparin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy*; D012307:Risk Factors; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000188:drug therapy*
chemical_list: D017985:Dalteparin
keywords: D-dimer; Dalteparin; Multiple myeloma; Venous thromboembolism