Abstract：
Thrombosis represents a frequent and potentially severe complication in individuals diagnosed with multiple myeloma (MM). These events can be driven by both the disease as well as the therapies themselves. Overall, available evidence is inconclusive about the differential thrombogenicity of carfilzomib/lenalidomide/dexamethasone (KRd) and bortezomib/lenalidomide/dexamethasone (VRd). This meta-analysis compares the risk for venous thromboembolism (VTE; including deep venous thrombosis and pulmonary embolism) and arterial thromboembolism (ATE; including myocardial infarction and ischemic stroke) with KRd versus VRd as primary therapy for newly diagnosed MM (NDMM). Out of 510 studies identified after deduplication, one randomized controlled trial and five retrospective cohort studies were included. We analyzed 2304 patients (VRd: 1380; KRd: 924) for VTE events and 2179 patients (VRd: 1316; KRd: 863) for ATE events. Lower rates of VTE were observed in the VRd group when compared with the KRd group (6.16% vs. 8.87%; odds ratio [OR], 0.53; 95% confidence interval [CI], 0.32-0.88; p = .01). Both treatment groups exhibited minimal ATE incidence, with no significant difference between them (0.91% vs. 1.16%; OR, 1.01; 95% CI, 0.24-4.20; p = .99). In view of potential biases from retrospective studies, heterogeneity of baseline population characteristics, and limited access to patient-level data (e.g., VTE risk stratification and type of thromboprophylaxis regimen used) inherent to this meta-analysis, additional research is warranted to further validate our findings and refine strategies for thrombosis prevention in MM.
摘要：
在诊断为多发性骨髓瘤（MM）的个体中，血栓形成是一种常见且潜在的严重并发症。这些事件可以由疾病以及疗法本身驱动。总的来说,现有证据对卡非佐米/来那度胺/地塞米松(KRd)和硼替佐米/来那度胺/地塞米松(VRd)的不同血栓形成性尚无定论.这项荟萃分析比较了静脉血栓栓塞（VTE；包括深静脉血栓形成和肺栓塞）和动脉血栓栓塞（ATE；包括心肌梗死和缺血性卒中）的风险，KRd与VRd作为新诊断的MM（NDMM）的主要治疗方法。在重复数据删除后确定的510项研究中，纳入1项随机对照试验和5项回顾性队列研究.我们分析了2304例患者（VRd：1380；KRd：924）的VTE事件和2179例患者（VRd：1316；KRd：863）的ATE事件。与KRd组相比，VRd组的VTE发生率较低（6.16％vs.8.87%；赔率比[OR]，0.53；95%置信区间[CI]，0.32-0.88；p=0.01）。两个治疗组表现出最低的ATE发生率，它们之间没有显著差异(0.91%与1.16%；或，1.01；95%CI，0.24-4.20；p=.99）。鉴于回顾性研究的潜在偏见，基线人群特征的异质性，以及对患者级别数据的有限访问(例如，VTE风险分层和使用的血栓预防方案类型）固有的荟萃分析，我们需要更多的研究来进一步验证我们的发现,并完善MM中血栓预防的策略.
