Document Detail


High incidence of arterial thrombosis in young patients treated for multiple myeloma: results of a prospective cohort study.
MedLine Citation:
PMID:  20339094     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This prospective study evaluated the risk of arterial thrombosis in 195 consecutive patients aged 18 to 65 years with newly diagnosed multiple myeloma (MM). All patients were treated with 3 cycles of VAD (vincristine, doxorubicin, and dexamethasone) or TAD (thalidomide-AD) or PAD (bortezomib-AD) in national trials, followed by high-dose melphalan and autologous stem cell transplantation. For a period of 522 patient-years, 11 of the 195 patients (5.6%) developed arterial thrombosis. The highest incidence was seen during induction chemotherapy courses. Median age at onset of arterial thrombosis was 59 years (range, 43-65 years). Hypertension and smoking were significantly associated with arterial thrombosis with a relative risk of 11.7 (2.23-61.2) and 15.2 (1.78-130), respectively. Factor VIII levels (FVIII:C) correlated significantly with age (P = .02) and higher International Scoring System (ISS) stage (P = .001). A higher FVIII:C was associated with arterial thrombosis (hazard ratio [HR] = 1.85; 95% confidence interval [CI] = 0.99-3.47) after adjustment for age, ISS score, and assigned treatment arm. MM patients have an increased risk for arterial thrombotic events during and after induction chemotherapy. Hypertension, smoking, and high factor VIII levels, possibly reflecting disease activity, contribute to the risk of arterial thrombosis.
Authors:
Eduard J Libourel; Pieter Sonneveld; Bronno van der Holt; Moniek P M de Maat; Frank W G Leebeek
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Publication Detail:
Type:  Journal Article     Date:  2010-03-25
Journal Detail:
Title:  Blood     Volume:  116     ISSN:  1528-0020     ISO Abbreviation:  Blood     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-09     Completed Date:  2010-08-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7603509     Medline TA:  Blood     Country:  United States    
Other Details:
Languages:  eng     Pagination:  22-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Hematology, Erasmus University Medical Centre, Rotterdam, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols / adverse effects,  therapeutic use*
Boronic Acids / administration & dosage
Clinical Trials, Phase III as Topic
Dexamethasone / administration & dosage
Doxorubicin / administration & dosage
Female
Humans
Incidence
Male
Middle Aged
Multiple Myeloma / complications*,  drug therapy*
Multivariate Analysis
Outcome Assessment (Health Care) / statistics & numerical data
Proportional Hazards Models
Prospective Studies
Pyrazines / administration & dosage
Randomized Controlled Trials as Topic
Risk Assessment / statistics & numerical data
Risk Factors
Thalidomide / administration & dosage
Thrombosis / epidemiology,  etiology*
Vincristine / administration & dosage
Chemical
Reg. No./Substance:
0/Boronic Acids; 0/Pyrazines; 0/bortezomib; 23214-92-8/Doxorubicin; 50-02-2/Dexamethasone; 50-35-1/Thalidomide; 57-22-7/Vincristine
Comments/Corrections
Comment In:
Blood. 2010 Jul 8;116(1):2-3   [PMID:  20616223 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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