TY - JOUR
T1 - Thalidomide and deep vein thrombosis in multiple myeloma
T2 - Risk factors and effect on survival
AU - Zangari, Maurizio
AU - Barlogie, Bart
AU - Thertulien, Raymond
AU - Jacobson, Joth
AU - Eddleman, Paul
AU - Fink, Louis
AU - Fassas, Athanasios
AU - Van Rhee, Frits
AU - Talamo, Giampaolo
AU - Lee, Choon Kee
AU - Tricot, Guido
PY - 2003/6
Y1 - 2003/6
N2 - Thalidomide has antiangiogenic properties and was found to be effective in patients with multiple myeloma (MM) when used in the setting of posttransplantation relapse. We have now analyzed risk factors associated with development of deep vein thrombosis (DVT) in a cohort of 535 patients treated with thalidomide with cytotoxic chemotherapy (VAD [vincristine/doxorubicin/dexamethasone], CAD [cyclophosphamide/doxorubicin/dexamethasone], DCEP [dexamethasone/cyclophosphamide/etoposide/cisplatin], or DT-PACE or without cytotoxic chemotherapy (thalidomide and dexamethasone only). A total of 82 patients developed DVT, and the frequency was affected by a number of baseline characteristics. On multivariate analysis, the combination of thalidomide with chemotherapy including doxorubicin was associated with the highest odds ratio (OR) for DVT (4.3; P≤ 0.001); in addition, newly diagnosed disease (OR, 2.5; P = 0.001) and chromosome 11 abnormality (OR, 1.8; P = 0.048) were also independent predictors for DVT. With a median follow-up of 2.9 years, survival was inferior in patients with chromosome 13 abnormalities (P = 0.001), age > 60 years (P= 0.001), lactate dehydrogenase level ≥ 190 IU/L (P = 0.002), and creatinine level ≥ 2 mg/dL (P < 0.001). However, the development of DVT did not adversely affect survival when examined as a time-dependent variable and adjusted for standard risk features (hazard ratio, 0.8; P = 0.162).
AB - Thalidomide has antiangiogenic properties and was found to be effective in patients with multiple myeloma (MM) when used in the setting of posttransplantation relapse. We have now analyzed risk factors associated with development of deep vein thrombosis (DVT) in a cohort of 535 patients treated with thalidomide with cytotoxic chemotherapy (VAD [vincristine/doxorubicin/dexamethasone], CAD [cyclophosphamide/doxorubicin/dexamethasone], DCEP [dexamethasone/cyclophosphamide/etoposide/cisplatin], or DT-PACE or without cytotoxic chemotherapy (thalidomide and dexamethasone only). A total of 82 patients developed DVT, and the frequency was affected by a number of baseline characteristics. On multivariate analysis, the combination of thalidomide with chemotherapy including doxorubicin was associated with the highest odds ratio (OR) for DVT (4.3; P≤ 0.001); in addition, newly diagnosed disease (OR, 2.5; P = 0.001) and chromosome 11 abnormality (OR, 1.8; P = 0.048) were also independent predictors for DVT. With a median follow-up of 2.9 years, survival was inferior in patients with chromosome 13 abnormalities (P = 0.001), age > 60 years (P= 0.001), lactate dehydrogenase level ≥ 190 IU/L (P = 0.002), and creatinine level ≥ 2 mg/dL (P < 0.001). However, the development of DVT did not adversely affect survival when examined as a time-dependent variable and adjusted for standard risk features (hazard ratio, 0.8; P = 0.162).
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U2 - 10.3816/CLM.2003.n.011
DO - 10.3816/CLM.2003.n.011
M3 - Article
C2 - 12837152
AN - SCOPUS:0038692110
SN - 1526-9655
VL - 4
SP - 32
EP - 35
JO - Clinical Lymphoma
JF - Clinical Lymphoma
IS - 1
ER -