Predictors of deep vein thrombosis (DVT) in newly diagnosed multiple myeloma (MM) patients with and without prophylactic recombinant erythropoietin (EPO) therapy

Autor: Carol Beth Stewart, Kimberly D. Lockhart, Robert L. Kennedy, Clyde Bailey, Elias Anaissie, Elizabeth Ann Coleman
Rok vydání: 2009
Předmět:
Zdroj: Journal of Clinical Oncology. 27:9554-9554
ISSN: 1527-7755
0732-183X
DOI: 10.1200/jco.2009.27.15_suppl.9554
Popis: 9554 Background: DVT, a complication among newly diagnosed MM patients, is most common during the first 3–4 months of therapy. EPO, given to treat anemia in patients receiving chemotherapy, has been associated with increased DVT risk and the mechanism, thought to be related to rise in hemoglobin, remains unknown. Methods: All 604 patients with newly diagnosed MM who completed the induction phase (∼ 3–4 months) of treatment were included. Induction consisted of multiagent chemotherapy with upfront randomization to thalidomide (THAL) or no THAL. 122 patients were also enrolled in an exercise study that included prophylactic EPO. Venous thromboembolism, defined as Doppler confirmed DVT and/or pulmonary embolus during induction, was the primary endpoint. Univariate analyses provided group comparisons. Logistic regression analysis determined predictors of DVT. Results: EPO and No EPO groups were similar for THAL use, age, race, gender, BMI, DVT history, and key baseline laboratory values except for lower cytogenetics risk score (p = 0.010) and higher albumin (p = 0.005), hemoglobin (p = 0.025) and fibrinogen (p = 0.0005) in the EPO group. EPO patients had a higher incidence of DVT 25 (20.5%) vs. 47 (9.8%) (p = 0.001). Risk factors for DVT by univariate analysis were THAL (p =0.001) and baseline platelets > 350,000/μL (p = 0.018) but not hemoglobin (at baseline or throughout study). There were no significant differences in MM response or survival between the groups with and without DVT. Compared to the No EPO group, EPO-treated patients had a better MM response (p = 0.023) and a higher survival (p = 0.0005). The main predictors of DVT by logistic regression were THAL and prophylactic EPO. Conclusions: THAL and prophylactic EPO predict for higher risk of DVT among newly diagnosed MM patients. Hemoglobin levels were not related to higher risk of DVT. DVT and EPO did not decrease treatment response or survival. No significant financial relationships to disclose.
Databáze: OpenAIRE
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