Thrombogenic activity of doxorubicin in myeloma patients receiving thalidomide: implications for therapy

DOI PDF 被引用文献8件
  • Maurizio Zangari
    From the Central Arkansas Veterans Healthcare System; and University of Arkansas for Medical Sciences, Little Rock, AR.
  • Eric Siegel
    From the Central Arkansas Veterans Healthcare System; and University of Arkansas for Medical Sciences, Little Rock, AR.
  • Bart Barlogie
    From the Central Arkansas Veterans Healthcare System; and University of Arkansas for Medical Sciences, Little Rock, AR.
  • Elias Anaissie
    From the Central Arkansas Veterans Healthcare System; and University of Arkansas for Medical Sciences, Little Rock, AR.
  • Fariba Saghafifar
    From the Central Arkansas Veterans Healthcare System; and University of Arkansas for Medical Sciences, Little Rock, AR.
  • Athanasios Fassas
    From the Central Arkansas Veterans Healthcare System; and University of Arkansas for Medical Sciences, Little Rock, AR.
  • Christopher Morris
    From the Central Arkansas Veterans Healthcare System; and University of Arkansas for Medical Sciences, Little Rock, AR.
  • Louis Fink
    From the Central Arkansas Veterans Healthcare System; and University of Arkansas for Medical Sciences, Little Rock, AR.
  • Guido Tricot
    From the Central Arkansas Veterans Healthcare System; and University of Arkansas for Medical Sciences, Little Rock, AR.

抄録

<jats:p>Ten percent of newly diagnosed myeloma patients treated with any type of chemotherapy develop deep venous thrombosis (DVT). Thalidomide has proven activity in refractory multiple myeloma (MM), and although single-agent thalidomide has minimal prothrombogenic activity, its combination with cytotoxic chemotherapy is associated with a significantly increased risk of DVT. We analyzed the incidence of DVT in 232 MM patients who received a combination of chemotherapy and thalidomide on 2 protocols that differed only by the inclusion of doxorubicin in one. DT-PACE (dexamethasone/thalidomide/cisplatin/doxorubicin/cyclophos- phanide/etoposide) was offered to patients with preceding standard dose therapy, but no prior autotransplantation, while DCEP-T (dexamethasone/cyclophosphamide/etoposide/cisplatin/thalidomide) was administered for relapse after transplantation. If there were signs or symptoms suggestive of DVT, patients received additional investigations, including Doppler ultrasonography, followed by venography if indicated. Only patients on DT-PACE but not DCEP-T experienced an increased incidence of DVT. A statistical association between the incidence of DVT and combination chemotherapy including doxorubicin (P = .02) was observed; this association was confirmed on multivariate analysis. MM patients treated with thalidomide and doxorubicin have a high risk of developing DVT.</jats:p>

収録刊行物

  • Blood

    Blood 100 (4), 1168-1171, 2002-08-15

    American Society of Hematology

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