title: A review of the venous thrombotic issues associated with multiple myeloma.
abstract: BACKGROUND
  Patients with multiple myeloma (MM) have an increased risk of venous thromboembolic (VTE) complications. The first reports of high VTE rates date back to 1999 but became more apparent with the introduction of novel agents in the treatment of MM and mostly with immunomodulatory drugs (IMiDs; thalidomide, lenalidomide and pomalidomide).
  
  
  METHODS
  Currently thromboprophylaxis is recommended for patients who receive IMiDs-based regimens and the type of thrombophrophylaxis is based on patient-, disease- and treatment-related risk factors. Making the distinction between the intrinsic risk of thrombosis in MM and the effect of therapy is crucial. The use of aspirin, low molecular weight heparins and warfarin are the recommended drugs but despite their appropriate use the rates of VTE are not completely eliminated. Expert commentary: Research into biomarkers of increased coagulability and their incorporation in risk assessment models could identify patients most likely to benefit from thromboprophylaxis but such models are not widely used in myeloma.
authors.affiliation: a Department of Clinical Therapeutics , National and Kapodistrian University of Athens, School of Medicine , Athens , Greece.
authors.forename: Despina
authors.initials: D
authors.lastname: Fotiou
authors.affiliation: b INSERM U938, Faculté de Médecine Pierre et Marie Curie , Université Paris VI , Paris , France.|c Thrombosis Center, Service d'Hématologie Biologique Hôpital Tenon , Hôpitaux Universitaires de l'Est Parisien, Assistance Publique Hôpitaux de Paris , Paris , France.
authors.forename: Grigoris
authors.initials: G
authors.lastname: Gerotziafas
authors.affiliation: a Department of Clinical Therapeutics , National and Kapodistrian University of Athens, School of Medicine , Athens , Greece.
authors.forename: Efstathios
authors.initials: E
authors.lastname: Kastritis
authors.affiliation: a Department of Clinical Therapeutics , National and Kapodistrian University of Athens, School of Medicine , Athens , Greece.
authors.forename: Meletios A
authors.initials: MA
authors.lastname: Dimopoulos
authors.affiliation: a Department of Clinical Therapeutics , National and Kapodistrian University of Athens, School of Medicine , Athens , Greece.
authors.forename: Evangelos
authors.initials: E
authors.lastname: Terpos
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D015415:Biomarkers; D001777:Blood Coagulation; D020022:Genetic Predisposition to Disease; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007155:Immunologic Factors / Q000009:adverse effects / Q000627:therapeutic use; D009101:Multiple Myeloma / Q000097:blood* / Q000150:complications* / Q000188:drug therapy; D011292:Premedication; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000209:etiology* / Q000517:prevention & control; D014859:Warfarin / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D015415:Biomarkers; D006495:Heparin, Low-Molecular-Weight; D007155:Immunologic Factors; D014859:Warfarin
keywords: Microparticles; Multiple myeloma; immunomodulatory drugs; risk assessment models; thromboprophylaxis; venous thromboembolism