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Aspirin or enoxaparin thromboprophylaxis for newly-diagnosed multiple myeloma patients treated with lenalidomide
Blood, 08/15/2011
Clinical Article
Larocca A et al. –In previously untreated MM patients receiving lenalidomide with a low thromboembolic risk, ASA could be an effective and less-expensive alternative to LMWH thromboprophylaxis.
Methods- Prospective, open-label, randomized substudy of a phase 3 trial
- Compared efficacy and safety of thromboprophylaxis with low-dose aspirin (ASA) or low-molecular-weight heparin (LMWH) in newly-diagnosed MM patients, treated with lenalidomide and low-dose dexamethasone (Rd) induction and melphalan-prednisone-lenalidomide consolidation
- 342 patients who did not have clinical indications or contraindications to antiplatelet or anticoagulant therapy, were randomized to receive ASA 100 mg/day (n=176) or LMWH enoxaparin 40 mg/day (n=166)
- Incidence of VTE was 2.27% in ASA group and 1.20% in LMWH group
- Incidence of VTE was 2.27% in the ASA group and 1.20% in the LMWH group
- Compared with LMWH, absolute difference in proportion of VTE was +1.07% (95% CI, -1.69 to 3.83; P = 0.452) in the ASA group
- Pulmonary embolism was observed in 1.70% of patients in ASA group and none in the LMWH group
- No arterial thrombosis, acute cardiovascular events, or sudden deaths were reported
- No major hemorrhagic complications reported
