title: Successful management of venous thromboembolism with apixaban in a multiple myeloma patient on lenalidomide therapy.
abstract: A 69-year-old man was diagnosed with multiple myeloma (IgG-κ) in January 2012. He received autologous hematopoietic stem cell transplantation in August 2012 and subsequently maintained a stringent complete remission. In March 2016, he relapsed and was treated with lenalidomide and low-dose dexamethasone (Ld). On day22, he developed an asymptomatic venous thromboembolism (VTE) despite receiving prophylactic aspirin treatment. Thus, heparin and warfarin were administered. However, his prothrombin time-international normalized ratio did not remain within the target range of 2-3. Therefore, 10 mg/day of apixaban, a factor Xa inhibitor, was administered. The apixaban treatment resulted in favorable and effective control of the patient's VTE on day33. He has continued to receive Ld treatment and has suffered no further VTE or bleeding. Further large studies are needed to assess the efficacy and safety of factor Xa inhibitors for the treatment of MM-associated VTE.
authors.affiliation: Division of Hematology, Japanese Red Cross Society Wakayama Medical Center.
authors.forename: Satoko
authors.initials: S
authors.lastname: Oka
authors.forename: Suguru
authors.initials: S
authors.lastname: Takeuchi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Shiragami
authors.forename: Keigo
authors.initials: K
authors.lastname: Hamahata
authors.forename: Masaharu
authors.initials: M
authors.lastname: Nohgawa
mesh_terms: D000368:Aged; D065427:Factor Xa Inhibitors / Q000627:therapeutic use*; D006801:Humans; D000077269:Lenalidomide; D008297:Male; D009101:Multiple Myeloma / Q000150:complications / Q000188:drug therapy*; D011720:Pyrazoles / Q000627:therapeutic use*; D011728:Pyridones / Q000627:therapeutic use*; D013792:Thalidomide / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000188:drug therapy* / Q000209:etiology
chemical_list: D065427:Factor Xa Inhibitors; D011720:Pyrazoles; D011728:Pyridones; C522181:apixaban; D013792:Thalidomide; D000077269:Lenalidomide