Abstract：
OBJECTIVE: The aim of this study is to assess international guidelines implementation concerning thromboprophylaxis strategy in myeloma patients treated with immunomodulatory drugs.
METHODS: This retrospective study includes multiple myeloma patients treated with immunomodulatory drugs between 2014 and 2017 in the Hematology department of a teaching hospital (Hospices Civils de Lyon, France) and followed by the multidisciplinary care plan for cancer outpatients ONCORAL (ONCological care for outpatients with ORAL anticancer drugs). Data from immunomodulatory drugs administration, thromboprophylaxis strategy and thrombotic events were collected from medical files. Adherence to 2010 International Myeloma Working Group (IMWG) guidelines was assessed.
RESULTS: 213 patients received at least one immunomodulatory drug: lenalidomide (60.9%), pomalidomide (24.0%) and thalidomide (15.1%). About two third of treatment lines (66.2%) were in accordance with IMWG recommendations. Among the others, 30.5% and 69.5% had thromboprophylaxis, respectively, superior or inferior to IMWG recommendations. 37 venous thrombotic events and 4 arterial thromboembolisms (one patient experienced both a stroke and deep venous thrombosis simultaneously) were reported.
CONCLUSIONS: Thromboprophylaxis was systematically performed in myeloma patients treated with immunomodulatory drugs in this real-life retrospective cohort. However, the choice of anticoagulant or anti-platelet agent remains debatable, as adherence to existing guidelines was variable.
METHODS: This retrospective study includes multiple myeloma patients treated with immunomodulatory drugs between 2014 and 2017 in the Hematology department of a teaching hospital (Hospices Civils de Lyon, France) and followed by the multidisciplinary care plan for cancer outpatients ONCORAL (ONCological care for outpatients with ORAL anticancer drugs). Data from immunomodulatory drugs administration, thromboprophylaxis strategy and thrombotic events were collected from medical files. Adherence to 2010 International Myeloma Working Group (IMWG) guidelines was assessed.
RESULTS: 213 patients received at least one immunomodulatory drug: lenalidomide (60.9%), pomalidomide (24.0%) and thalidomide (15.1%). About two third of treatment lines (66.2%) were in accordance with IMWG recommendations. Among the others, 30.5% and 69.5% had thromboprophylaxis, respectively, superior or inferior to IMWG recommendations. 37 venous thrombotic events and 4 arterial thromboembolisms (one patient experienced both a stroke and deep venous thrombosis simultaneously) were reported.
CONCLUSIONS: Thromboprophylaxis was systematically performed in myeloma patients treated with immunomodulatory drugs in this real-life retrospective cohort. However, the choice of anticoagulant or anti-platelet agent remains debatable, as adherence to existing guidelines was variable.
摘要：
目的：本研究的目的是评估在接受免疫调节药物治疗的骨髓瘤患者中有关血栓预防策略的国际指南实施情况。
方法：这项回顾性研究包括2014年至2017年在教学医院血液科接受免疫调节药物治疗的多发性骨髓瘤患者（临终关怀CivilsdeLyon，法国），然后是癌症门诊患者的多学科护理计划ONCORAL（口服抗癌药物门诊患者的ONCological护理）。免疫调节药物给药的数据，血栓预防策略和血栓事件收集自医学档案.对2010年国际骨髓瘤工作组（IMWG）指南的遵守情况进行了评估。
结果：213例患者接受了至少一种免疫调节药物：来那度胺（60.9%），泊马度胺（24.0%）和沙利度胺（15.1%）。约三分之二的治疗线（66.2％）符合IMWG建议。在其他人中，30.5%和69.5%有血栓预防，分别,优于或低于IMWG建议。报告了37例静脉血栓形成事件和4例动脉血栓栓塞(1例患者同时出现卒中和深静脉血栓形成)。
结论：在这个现实生活中的回顾性队列中，对接受免疫调节药物治疗的骨髓瘤患者进行了系统的血栓预防。然而,抗凝剂或抗血小板剂的选择仍有争议，因为对现有指南的坚持是可变的。
方法：这项回顾性研究包括2014年至2017年在教学医院血液科接受免疫调节药物治疗的多发性骨髓瘤患者（临终关怀CivilsdeLyon，法国），然后是癌症门诊患者的多学科护理计划ONCORAL（口服抗癌药物门诊患者的ONCological护理）。免疫调节药物给药的数据，血栓预防策略和血栓事件收集自医学档案.对2010年国际骨髓瘤工作组（IMWG）指南的遵守情况进行了评估。
结果：213例患者接受了至少一种免疫调节药物：来那度胺（60.9%），泊马度胺（24.0%）和沙利度胺（15.1%）。约三分之二的治疗线（66.2％）符合IMWG建议。在其他人中，30.5%和69.5%有血栓预防，分别,优于或低于IMWG建议。报告了37例静脉血栓形成事件和4例动脉血栓栓塞(1例患者同时出现卒中和深静脉血栓形成)。
结论：在这个现实生活中的回顾性队列中，对接受免疫调节药物治疗的骨髓瘤患者进行了系统的血栓预防。然而,抗凝剂或抗血小板剂的选择仍有争议，因为对现有指南的坚持是可变的。
