Prevention of thalidomide and lenalidomide associated thrombosis in myeloma

This manuscript intends to explain prophylaxis strategies for venous thromboembolism (VTE). VTE is more common in cancer patients than in the general population, whose VTE occurrence is more than 1 in every thousand. In the context of multiple myeloma patients, their risk of VTE increases when thalidomide or lenalidomide are part of their treatment regimens. Some individual factors that put a patient at risk based of thalidomide or lenalidomide therapy are the following:

  • age
  • history of VTE
  • central venous catheter
  • comorbidities
  • immobilization
  • surgery
  • inherited thrombophilia

Dexamethasone, doxorubicin, and multiagent chemotherapy when used in combination with thalidomide or lenalidomide also contribute to higher VTE risk. Low molecular weight heparin (LMWH), warfarin, and aspirin are prophylaxis methods for VTE, but not enough research has been done to determine the best method for VTE.


Palumbo A, Rajkumar SV, Dimopoulos MA, Richardson PG, San Miguel J, Barlogie B, Harousseau J, Zonder JA, Cavo M, Zangari M, Attal M, Belch A, Knop S, Joshua D, Sezer O, Ludwig H, Vesole D, Blade J, Kyle R, Westin J, Weber D, Bringhen S, Niesvizky R, Waage A, von Lilienfeld-Toal M, Lonial S, Morgan GJ, Orlowski RZ, Shimizu K, Anderson KC, Boccadoro M, Durie BG, Sonneveld P, Hussein MA; International Myeloma Working Group.

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