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JCO Early Release, published online ahead of print Nov 9 2009
Journal of Clinical Oncology, 10.1200/JCO.2009.23.0169

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Received March 17, 2009
Accepted August 19, 2009

Survival Effect of Venous Thromboembolism in Patients With Multiple Myeloma Treated With Lenalidomide and High-Dose Dexamethasone

Maurizio Zangari,* Guido Tricot, Latha Polavaram, Fenghuang Zhan, Ashlie Finlayson, Robert Knight, Tommy Fu, Donna Weber, Meletios A. Dimopoulos, Ruben Niesvizky, and Louis Fink

From the Division of Hematology, Blood/Marrow Transplant and Myeloma Program, University of Utah, Salt Lake City, UT; Celgene, Summit, NJ; The University of Texas M. D. Anderson Cancer Center, Houston, TX; University of Athens School of Medicine, Athens, Greece; Cornell University, New York Presbyterian Hospital, New York, NY; and Laboratory Medicine, Nevada Cancer Institute, Las Vegas, NV.

* To whom correspondence should be addressed. E-mail: maurizio.zangari{at}hsc.utah.edu

Purpose: We conducted a retrospective analysis of the survival effect of venous thromboembolism (VTE) development in patients with multiple myeloma (MM).

Methods: Two identically designed, multicenter, double-blind, phase III clinical trials (MM-009 and MM-010) were conducted in Europe and the United States to assess the effect of lenalidomide in combination with dexamethasone versus dexamethasone plus placebo in patients with relapsed or refractory MM, after failing at least one prior line of treatment. In this retrospective analysis, we evaluated incidence and survival effect of thromboembolism in 353 patients randomly assigned to receive 25 mg of lenalidomide on days 1 through 21 of a 28-day cycle, plus 40 mg of oral dexamethasone on days 1 through 4, 9 through 12, and 17 through 20 for the first four cycles; after the fourth cycle, 40 mg of dexamethasone was administered on days 1 through 4 only.

Results: Seventeen percent of patients experienced a thromboembolic episode. The development of VTE did not significantly affect overall survival (P = .90) or time to progression (P = .34). No significant survival impact was observed in a subgroup of patients who received prophylactic anticoagulation (overall survival P = .7, time to progression P = .1).

Conclusion: Patients with MM treated with lenalidomide and high-dose dexamethasone who developed a VTE did not experience shorter overall survival or time to progression.


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Copyright © 2009 by the American Society of Clinical Oncology, Online ISSN: 1527-7755. Print ISSN: 0732-183X
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