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

Korean Multiple Myeloma 151 Investigators

Research output: Contribution to journalArticle

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 languageEnglish
Pages (from-to)79-90
Number of pages12
JournalInternational Journal of Hematology
Volume109
Issue number1
DOIs
Publication statusPublished - 2019 Jan 22

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Venous Thromboembolism
Multiple Myeloma
Dexamethasone
Incidence
lenalidomide
Insurance
Medical Records
Cohort Studies
Retrospective Studies
Databases
Delivery of Health Care
Survival

All Science Journal Classification (ASJC) codes

  • Hematology

Cite this

@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 Jinseok Kim 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}",
year = "2019",
month = "1",
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",
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}

Venous thromboembolism in relapsed or refractory multiple myeloma patients treated with lenalidomide plus dexamethasone. / Korean Multiple Myeloma 151 Investigators.

In: International Journal of Hematology, Vol. 109, No. 1, 22.01.2019, p. 79-90.

Research output: Contribution to journalArticle

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, Jinseok

AU - Lee, Yoo Jin

AU - Yoon, Sung Soo

AU - Jo, Jae Cheol

AU - Lee, Ho Sup

AU - Bang, Soo Mee

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

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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U2 - 10.1007/s12185-018-2540-1

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