On July 18, the Hutchinson Institute for Cancer Outcomes Research (based at the Fred Hutchinson Cancer Research Center, along with the University of Washington and Seattle Cancer Care Alliance) presented new research on a preventative approach doctors can take by predicting blood clots for multiple myeloma patients. The doctors will be able to evaluate which patients will need blood thinners (anticoagulants) to prevent clots with a certain set of risk factors.
Venous blood clots (known as VTE: venous thromboembolism) are associated with immunomodulatory drug treatment (IMiD) combined with moderate-high steroid dosage.
“VTE is common in patients with multiple myeloma receiving IMiDs, and can cause disability, delay or complicate chemotherapy, and—in rare cases—be fatal.” –Dr. Ang Li, University of Washington
The study’s senior author Kristen M. Sanfilippo, MD, MPHS was “surprised [to find] that prophylactic anticoagulation, in any form, is under-utilized despite of its inclusion in the NCCN Guidelines for Cancer-Associated VTE for more than 10 years now…”
Because IMiDs are becoming more popular as a myeloma treatment, patients and doctors should be aware of the ever-present and growing concern of VTE. Researchers encourage providers to use the new risk assessment model as a tool to help identify those patients at risk, and to take action as soon as possible.
The researchers looked at two different databases of different patient populations (2,397 patients in total) to identify risk factors for VTE. The five factors for risk were:
- Prior history of VTE
- Surgery within 90 days
- Being 80 or older
- High steroid doses
- Not being Asian
They assigned different points to each of these factors. Patients with a score of 2 or higher had VTE at 3 and 6 months at a rate of 7-12% vs. 4-7% for those with a score of one or lower.
Now that doctors know the risk factors, anti-coagulation can be more routinely used for these patients at a higher risk.