S. Vincent Rajkumar has received research support to cover the cost of clinical trials at Mayo Clinic from Celgene Corp.
Thromboembolic events with lenalidomide-based therapy for multiple myeloma
Article first published online: 15 FEB 2008
Copyright © 2008 American Cancer Society
Volume 112, Issue 7, pages 1522–1528, 1 April 2008
How to Cite
Menon, S. P., Rajkumar, S. V., Lacy, M., Falco, P. and Palumbo, A. (2008), Thromboembolic events with lenalidomide-based therapy for multiple myeloma. Cancer, 112: 1522–1528. doi: 10.1002/cncr.23336
- Issue published online: 19 MAR 2008
- Article first published online: 15 FEB 2008
- Manuscript Accepted: 25 OCT 2007
- Manuscript Revised: 22 OCT 2007
- Manuscript Received: 19 JUL 2007
- Università degli Studi di Torino
- Fondazione Neoplasie Sangue Onlus
- Associazione Italiana Leucemie
- Compagnia di S Paolo
- Fondazione Cassa di Risparmio di Torino
- Ministero dell'Università e della Ricerca (MIUR)
- Consiglio Nazionale delle Ricerche (CNR); Italy
- National Institutes for Health. Grant Numbers: CA 62242, CA107476, CA 100080, CA 93842
- multiple myeloma;
The purpose was to evaluate the incidence and risk factors of thromboembolism associated with lenalidomide therapy in newly diagnosed myeloma.
A pooled analysis was performed of patients with previously untreated multiple myeloma enrolled in clinical trials of lenalidomide-based therapy at the Mayo Clinic, Rochester, Minnesota, and the Italian Myeloma Network, Italy. The incidence of thrombosis, the effect of risk factors such as steroid dose and erythropoietin supplementation, and the effect of prophylaxis were examined.
In all, 125 patients enrolled in 3 clinical trials were identified. Patients were stratified based on the concomitant corticosteroid dose. Fifty-two patients were in the high-dose group (dexamethasone 40 mg, 12 days a month); 73 patients were in the low-dose group (prednisone at any dose; or dexamethasone 40 mg, 4 days a month). A total of 110 patients were initiated on thromboprophylaxis; of these, 104 patients (95%) received aspirin. Ten patients (8%) developed deep vein thrombosis, including 4 who were not receiving any thromboprophylaxis at the time of the event. The rate of thromboembolic events was not different between patients who received concomitant erythropoietin therapy and those who did not, 4.8% and 8.6%, respectively (P = .54). A higher number of venous thrombotic episodes occurred in the high-dose corticosteroid group compared with the low-dose corticosteroid therapy group (12% vs 6%), but the difference was not statistically significant (P = .3).
The incidence of deep vein thrombosis is lower than previously reported in the literature. There was a trend to a higher incidence of thrombosis in patients receiving high-dose corticosteroid therapy. Cancer 2008. © 2008 American Cancer Society.