Venous Thromboembolism Risk in Patients With Newly Diagnosed Multiple Myeloma Treated with Carfilzomib or Bortezomib in Combination With Lenalidomide and Dexamethasone

Clin Lymphoma Myeloma Leuk. 2023 Nov;23(11):825-828. doi: 10.1016/j.clml.2023.07.009. Epub 2023 Jul 23.

Abstract

Background: Multiple myeloma (MM), as well as some treatments for MM, increase the risk of venous thromboembolism (VTE). Prior literature suggests carfilzomib, lenalidomide, and dexamethasone (KRd) may have a higher incidence of thromboembolic events compared with bortezomib, lenalidomide, and dexamethasone (VRd). We aimed to evaluate VTE risk with KRd induction compared to VRd at a large academic medical center in the United States.

Materials and methods: We retrospectively reviewed patients with newly diagnosed MM presenting at a single institution. Patients were followed for objectively diagnosed VTE events for 6 months following the start of induction therapy.

Results: A total of 209 patients were included, with 69 (33%) receiving KRd and 140 (67%) receiving VRd. Overall, 18 patients (9%) had a VTE event, with 5 (7%) in the KRd cohort and 13 (9%) in the VRd cohort (P = .80). Treatment with KRd was not associated with an increased risk of VTE compared to VRd (HR 0.74; 95% CI 0.26-2.08; P = .57).

Conclusion: In this cohort, KRd was not associated with an increase in VTE risk compared to VRd, contrary to prior literature.

Keywords: Deep vein thrombosis; Myeloma therapy; Pulmonary embolism; Thromboprophylaxis; Thrombosis.

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Bortezomib / adverse effects
  • Dexamethasone / therapeutic use
  • Humans
  • Lenalidomide / adverse effects
  • Multiple Myeloma* / complications
  • Multiple Myeloma* / drug therapy
  • Retrospective Studies
  • Venous Thromboembolism* / etiology

Substances

  • Lenalidomide
  • Bortezomib
  • carfilzomib
  • Dexamethasone