Venous thromboembolism in relapsed or refractory multiple myeloma patients treated with lenalidomide plus dexamethasone

Korean Multiple Myeloma 151 Investigators

doi:10.1007/s12185-018-2540-1

Venous thromboembolism in relapsed or refractory multiple myeloma patients treated with lenalidomide plus dexamethasone

Korean Multiple Myeloma 151 Investigators

Department of Internal Medicine

Research output: Contribution to journal › Article › peer-review

8 Citations (Scopus)

Abstract

Lenalidomide plus dexamethasone (LD) is currently the mainstay of treatment for both untreated and relapsed or refractory multiple myeloma (RRMM). Although lenalidomide-associated venous thromboembolism (VTE) is a major clinical concern, its incidence and prognostic impact have not been delineated. In this nationwide retrospective cohort study, we aimed to determine the cumulative incidence of VTE and its prognostic value using two consecutive cohorts of LD-treated RRMM patients: the KMM151 cohort (N = 542) and the HIRA cohort (N = 1559). Data were collected from medical records for the KMM151 cohort and healthcare insurance claims database for the HIRA cohort. Throughout the study period, 24 patients (4.4%) in the KMM151 cohort and 80 patients (5.1%) in the HIRA cohort developed VTE. The cumulative incidence reached a plateau approximately 2 years after LD initiation. The 2-year incidence was 4.9% in the KMM151 cohort and 8% in the HIRA cohort. Higher starting dose of lenalidomide, previous history of VTE, and older age were associated significantly with an increased VTE risk. Early-onset VTE was associated significantly with poor survival. In conclusion, VTE occurred in 5–8% of RRMM patients treated with LD over 2 years, and early-onset VTE was a strong indicator of poor prognosis.

Original language	English
Pages (from-to)	79-90
Number of pages	12
Journal	International Journal of Hematology
Volume	109
Issue number	1
DOIs	https://doi.org/10.1007/s12185-018-2540-1
Publication status	Published - 2019 Jan 22

Bibliographical note

Funding Information:
The authors thank the Korean Multiple Myeloma Working Party for developing and managing the KMM151 database and the KMM151 Investigators for contributing the data. We also thank Ju Hyun Lee, a data analyst at Seoul National University Bundang Hospital, for performing the statistical analysis. This work was supported by grants from the Korean Society on Thrombosis and Hemostasis (KSTH 2016-002) and Seoul National University Bundang Hospital (04-2012-003). This manuscript was edited by native English-speaking experts from BioScience Writers, Houston, TX, USA.

Funding Information:
Working Party for developing and managing the KMM151 database and the KMM151 Investigators for contributing the data. We also thank Ju Hyun Lee, a data analyst at Seoul National University Bundang Hospital, for performing the statistical analysis. This work was supported by grants from the Korean Society on Thrombosis and Hemostasis (KSTH 2016-002) and Seoul National University Bundang Hospital (04-2012-003). This manuscript was edited by native English-speaking experts from BioScience Writers, Houston, TX, USA.

Publisher Copyright:
© 2018, The Japanese Society of Hematology.

All Science Journal Classification (ASJC) codes

Hematology

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10.1007/s12185-018-2540-1

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@article{d3b0f7b7d91e46e3bfa5bbafd7803a39,

title = "Venous thromboembolism in relapsed or refractory multiple myeloma patients treated with lenalidomide plus dexamethasone",

abstract = "Lenalidomide plus dexamethasone (LD) is currently the mainstay of treatment for both untreated and relapsed or refractory multiple myeloma (RRMM). Although lenalidomide-associated venous thromboembolism (VTE) is a major clinical concern, its incidence and prognostic impact have not been delineated. In this nationwide retrospective cohort study, we aimed to determine the cumulative incidence of VTE and its prognostic value using two consecutive cohorts of LD-treated RRMM patients: the KMM151 cohort (N = 542) and the HIRA cohort (N = 1559). Data were collected from medical records for the KMM151 cohort and healthcare insurance claims database for the HIRA cohort. Throughout the study period, 24 patients (4.4%) in the KMM151 cohort and 80 patients (5.1%) in the HIRA cohort developed VTE. The cumulative incidence reached a plateau approximately 2 years after LD initiation. The 2-year incidence was 4.9% in the KMM151 cohort and 8% in the HIRA cohort. Higher starting dose of lenalidomide, previous history of VTE, and older age were associated significantly with an increased VTE risk. Early-onset VTE was associated significantly with poor survival. In conclusion, VTE occurred in 5–8% of RRMM patients treated with LD over 2 years, and early-onset VTE was a strong indicator of poor prognosis.",

author = "{Korean Multiple Myeloma 151 Investigators} and Junghoon Shin and Lee, {Je Jung} and Kihyun Kim and Min, {Chang Ki} and Lee, {Jeong Ok} and Cheolwon Suh and Kim, {Jin Seok} and Lee, {Yoo Jin} and Yoon, {Sung Soo} and Jo, {Jae Cheol} and Lee, {Ho Sup} and Bang, {Soo Mee} and Bang, {Soo Mee} and Yoon, {Dok Hyun} and Yoo Jin and Moon, {Joon Ho} and Inho Kim and Park, {Seong Kyu} and Shin, {Ho Jin} and Kim, {Min Kyoung} and Mun, {Yeung Chul} and Lee, {Mark Hong} and Yong Park and Eom, {Hyeon Seok} and Kim, {Hyo Jung} and Im, {Sung Nam} and Kim, {Sung Hyun} and Do, {Young Rok} and Lee, {Won Sik} and Cho, {Su Hee} and Yi, {Jun Ho} and Lee, {Jae Hoon}",

note = "Funding Information: The authors thank the Korean Multiple Myeloma Working Party for developing and managing the KMM151 database and the KMM151 Investigators for contributing the data. We also thank Ju Hyun Lee, a data analyst at Seoul National University Bundang Hospital, for performing the statistical analysis. This work was supported by grants from the Korean Society on Thrombosis and Hemostasis (KSTH 2016-002) and Seoul National University Bundang Hospital (04-2012-003). This manuscript was edited by native English-speaking experts from BioScience Writers, Houston, TX, USA. Funding Information: Working Party for developing and managing the KMM151 database and the KMM151 Investigators for contributing the data. We also thank Ju Hyun Lee, a data analyst at Seoul National University Bundang Hospital, for performing the statistical analysis. This work was supported by grants from the Korean Society on Thrombosis and Hemostasis (KSTH 2016-002) and Seoul National University Bundang Hospital (04-2012-003). This manuscript was edited by native English-speaking experts from BioScience Writers, Houston, TX, USA. Publisher Copyright: {\textcopyright} 2018, The Japanese Society of Hematology.",

year = "2019",

month = jan,

day = "22",

doi = "10.1007/s12185-018-2540-1",

language = "English",

volume = "109",

pages = "79--90",

journal = "International Journal of Hematology",

issn = "0925-5710",

publisher = "Springer Japan",

number = "1",

}

TY - JOUR

T1 - Venous thromboembolism in relapsed or refractory multiple myeloma patients treated with lenalidomide plus dexamethasone

AU - Korean Multiple Myeloma 151 Investigators

AU - Shin, Junghoon

AU - Lee, Je Jung

AU - Kim, Kihyun

AU - Min, Chang Ki

AU - Lee, Jeong Ok

AU - Suh, Cheolwon

AU - Kim, Jin Seok

AU - Lee, Yoo Jin

AU - Yoon, Sung Soo

AU - Jo, Jae Cheol

AU - Lee, Ho Sup

AU - Bang, Soo Mee

AU - Yoon, Dok Hyun

AU - Jin, Yoo

AU - Moon, Joon Ho

AU - Kim, Inho

AU - Park, Seong Kyu

AU - Shin, Ho Jin

AU - Kim, Min Kyoung

AU - Mun, Yeung Chul

AU - Lee, Mark Hong

AU - Park, Yong

AU - Eom, Hyeon Seok

AU - Kim, Hyo Jung

AU - Im, Sung Nam

AU - Kim, Sung Hyun

AU - Do, Young Rok

AU - Lee, Won Sik

AU - Cho, Su Hee

AU - Yi, Jun Ho

AU - Lee, Jae Hoon

N1 - Funding Information: The authors thank the Korean Multiple Myeloma Working Party for developing and managing the KMM151 database and the KMM151 Investigators for contributing the data. We also thank Ju Hyun Lee, a data analyst at Seoul National University Bundang Hospital, for performing the statistical analysis. This work was supported by grants from the Korean Society on Thrombosis and Hemostasis (KSTH 2016-002) and Seoul National University Bundang Hospital (04-2012-003). This manuscript was edited by native English-speaking experts from BioScience Writers, Houston, TX, USA. Funding Information: Working Party for developing and managing the KMM151 database and the KMM151 Investigators for contributing the data. We also thank Ju Hyun Lee, a data analyst at Seoul National University Bundang Hospital, for performing the statistical analysis. This work was supported by grants from the Korean Society on Thrombosis and Hemostasis (KSTH 2016-002) and Seoul National University Bundang Hospital (04-2012-003). This manuscript was edited by native English-speaking experts from BioScience Writers, Houston, TX, USA. Publisher Copyright: © 2018, The Japanese Society of Hematology.

PY - 2019/1/22

Y1 - 2019/1/22

N2 - Lenalidomide plus dexamethasone (LD) is currently the mainstay of treatment for both untreated and relapsed or refractory multiple myeloma (RRMM). Although lenalidomide-associated venous thromboembolism (VTE) is a major clinical concern, its incidence and prognostic impact have not been delineated. In this nationwide retrospective cohort study, we aimed to determine the cumulative incidence of VTE and its prognostic value using two consecutive cohorts of LD-treated RRMM patients: the KMM151 cohort (N = 542) and the HIRA cohort (N = 1559). Data were collected from medical records for the KMM151 cohort and healthcare insurance claims database for the HIRA cohort. Throughout the study period, 24 patients (4.4%) in the KMM151 cohort and 80 patients (5.1%) in the HIRA cohort developed VTE. The cumulative incidence reached a plateau approximately 2 years after LD initiation. The 2-year incidence was 4.9% in the KMM151 cohort and 8% in the HIRA cohort. Higher starting dose of lenalidomide, previous history of VTE, and older age were associated significantly with an increased VTE risk. Early-onset VTE was associated significantly with poor survival. In conclusion, VTE occurred in 5–8% of RRMM patients treated with LD over 2 years, and early-onset VTE was a strong indicator of poor prognosis.

AB - Lenalidomide plus dexamethasone (LD) is currently the mainstay of treatment for both untreated and relapsed or refractory multiple myeloma (RRMM). Although lenalidomide-associated venous thromboembolism (VTE) is a major clinical concern, its incidence and prognostic impact have not been delineated. In this nationwide retrospective cohort study, we aimed to determine the cumulative incidence of VTE and its prognostic value using two consecutive cohorts of LD-treated RRMM patients: the KMM151 cohort (N = 542) and the HIRA cohort (N = 1559). Data were collected from medical records for the KMM151 cohort and healthcare insurance claims database for the HIRA cohort. Throughout the study period, 24 patients (4.4%) in the KMM151 cohort and 80 patients (5.1%) in the HIRA cohort developed VTE. The cumulative incidence reached a plateau approximately 2 years after LD initiation. The 2-year incidence was 4.9% in the KMM151 cohort and 8% in the HIRA cohort. Higher starting dose of lenalidomide, previous history of VTE, and older age were associated significantly with an increased VTE risk. Early-onset VTE was associated significantly with poor survival. In conclusion, VTE occurred in 5–8% of RRMM patients treated with LD over 2 years, and early-onset VTE was a strong indicator of poor prognosis.

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UR - http://www.scopus.com/inward/citedby.url?scp=85054630091&partnerID=8YFLogxK

U2 - 10.1007/s12185-018-2540-1

DO - 10.1007/s12185-018-2540-1

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AN - SCOPUS:85054630091

SN - 0925-5710

VL - 109

SP - 79

EP - 90

JO - International Journal of Hematology

JF - International Journal of Hematology

IS - 1

ER -

Venous thromboembolism in relapsed or refractory multiple myeloma patients treated with lenalidomide plus dexamethasone

Abstract

Bibliographical note

All Science Journal Classification (ASJC) codes

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