Weight Adjusted Low-Dose Warfarin Decreases the Incidence of Thalidomide (T) Associated Venous Thromboembolism (VTE) in Patients (pts) with Multiple Myeloma (MM) and Waldenstroms Macroglobulinemia (WM)
| Autor: | Kena C. Miller, Swaminathan Padmanabhan, Rami Manochakian, Jean-Gabriel Coignet, Asher A. Chanan-Khan, Dawn DePaolo, Laurie Musial |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
medicine.medical_specialty
Aspirin education.field_of_study Bortezomib business.industry Immunology Population Warfarin Cell Biology Hematology medicine.disease Biochemistry Gastroenterology Surgery Thalidomide Regimen Internal medicine medicine cardiovascular diseases business education Dexamethasone Multiple myeloma medicine.drug |
| Zdroj: | Blood. 108:4101-4101 |
| ISSN: | 1528-0020 0006-4971 |
| Popis: | Introduction: T is an effective antimyeloma therapy. An important and problematic side effect of T is development of VTE. The underlying etiology of T associated VTE remains unknown, though a definite rise in its incidence is recorded when combined with other antimyeloma therapies such as dexamethasone (15%) and doxorubicin (26%). Defining an optimal way to prevent T associated VTE is important to improve patient’s quality of life and safety of T. We prospectively investigated the use of weight-adjusted, low-dose warfarin to decrease the incidence of VTE among pts treated with T based regimens. Methods: All pts treated with T-based therapies, at our institute were given VTE prophylaxis with 1 vs. 2mg warfarin for actual body weight Results: A total of 80 pts, 60 years (range 43–82), 35M and 45F are included in this analysis. Sixty three had stage III and 14 had ≤ stage II MM while 3 pts had WM. T was given with dex in 58 (72%) with dox in 57(71%) and with bortezomib in 32 (40%). Table 1 outlines the T based regimens used. IgG MM was noted in 39, IgA in 20 and 31 had other types of MM. Median T dose was 200 mg (range 50–300) and the median duration 4 months (range 1–6 months). Thirty two pts received 1mg and 48 received 2mg warfarin. Overall incidence of VTE was 6.25% (n=5). There were no bleeding complications noted with the use of warfarin in this pt population. Conclusion: Our study demonstrates for the first time that a weight adjusted low-dose warfarin approach in MM pts decreases the incidence of T associated VTE and can be safely instituted in pts treated with this important anti-myeloma therapy. Interestingly, none of the pts who received T with Doxil experienced any episode of VTE. Regimen No. of Patients Thalidomide Alone 1 Dexamethasone + Thalidomide 28 Bortezomib + Doxil + Thalidomide 24 VAD + Thalidomide 22 Bortezomib + Cyclophosphmaide + Dexamethasone + Thalidomide 5 |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|