Endothelial stress products and coagulation markers in patients with multiple myeloma treated with lenalidomide plus dexamethasone: an observational study
Autor: | Nikhil C. Munshi, Robert J. Soiffer, Mary Doyle, Gary Bradwin, Irene M. Ghobrial, Constantine S. Mitsiades, Fangxin Hong, Edie Weller, Leslie Lockridge, Diane Warren, Brendan Connell, Paul G. Richardson, Kenneth C. Anderson, Deanna Tocco, Rachel P. Rosovsky, Robert L. Schlossman |
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Rok vydání: | 2012 |
Předmět: |
Male
medicine.medical_specialty Homocysteine Fibrinogen Gastroenterology Dexamethasone Article chemistry.chemical_compound Stress Physiological Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Cluster Analysis Humans Prospective Studies Prospective cohort study Blood Coagulation Lenalidomide Multiple myeloma Aged Aged 80 and over business.industry Incidence Endothelial Cells Hematology Venous Thromboembolism Middle Aged medicine.disease Blood Coagulation Factors Thalidomide Vascular endothelial growth factor chemistry Immunology Female business Multiple Myeloma Biomarkers medicine.drug |
Zdroj: | British journal of haematology. 160(3) |
ISSN: | 1365-2141 |
Popis: | In this prospective study of patients with relapsed or relapsed and refractory multiple myeloma (MM) treated with lenalidomide and dexamethasone, relationships between markers of endothelial stress and drug administration and incidence of venous thromboembolism (VTE) were assessed. Of 33 enrolled patients, laboratory and treatment data were available for 32 patients. Of these, 23 received pulsed dexamethasone (40 mg/day on days 1-4, 9-12 and 17-21 of each 28-day cycle) and 9 received weekly dexamethasone (40 mg/day on days 1, 8, 15 and 21 of each cycle). The overall incidence of VTE was 9%. A decreasing trend in markers values was observed with intercellular adhesion molecule (P = 0·05), fibrinogen (P = 0·008), plasminogen activator inhibitor-1 (P 0·001), homocysteine (P = 0·002) and P-selectin (P 0·001) during therapy. Compared with weekly dexamethasone, pulsed dexamethasone was associated with significantly greater variation in mean adjusted relative values of fibrinogen, P-selectin and vascular endothelial growth factor (P 0·001 for all comparisons), although there was no apparent association with VTE incidence. Lenalidomide plus dexamethasone affects endothelial stress marker levels in patients with advanced MM. The higher variation seen with pulsed dexamethasone suggests greater endothelial stress with this approach. |
Databáze: | OpenAIRE |
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