Predicting Risk of Venous Thromboembolism in Multiple Myeloma: The Impede VTE Score

摘要: Introduction: Venous thromboembolism (VTE) is a common cause of morbidity and mortality among patients with multiple myeloma (MM). Thromboprophylaxis safe effective way to decrease VTE in other high-risk populations. Current guidelines recommend use thromboprophylaxis MM at VTE, but no validated model predicts MM. A risk prediction for would allow while sparing those low risk. Therefore, we sought develop Patients Methods: Using nationwide cohort Veterans, identified 4,448 diagnosed between 1999 2014. We retrospectively followed 180 days after start chemotherapy. candidate factors through literature review inclusion into the time-to-event models. used methods Fine Gray time accounting competing (non-VTE) death. To minimize immortal bias, all treatment variables were entered as time-varying variables. backward, step-wise approach, retained p ≤ 0.05, or Results: The median from diagnosis was 37 days. total 53 (5.7%) developed within 6 months MM-specific therapy. mean chemotherapy 69 days, 69% events occurring first 3 associated combined IMPEDE score (IMID points, BMI 1 point, Pathologic fracture pelvis/femur 2 ESA Dexamethasone (High-dose 4 Low-Dose points)/Doxorubicin Ethnicity/Race= Asian -3 history Tunneled line/CVC points) (Table 1). In addition, therapeutic anticoagulation (-5 warfarin molecular weight heparin (LWMH) prophylactic LMWH aspirin (-2 decreased VTE. showed satisfactory discrimination both derivation (Harrell9s c-statistic = 0.66) bootstrap validation, 0.65 (95% CI: 0.62 - 0.69). three groups, incident rate 6-months starting 3.1% scores (low-risk), 7.5% 4-6 (intermediate-risk), 13.3% ≥ 7 (high-risk). developing significantly higher intermediate- compared low-risk 2). Conclusions Relevance: rule, which can identify could guide clinicians selecting Disclosures Sanfilippo:BMS/Pfizer: Speakers Bureau. Wang:Daiichi Sankyo: Consultancy, Other: Travel. Wildes:Janssen: Research Funding. Mikhael:Onyx, Celgene, Sanofi, AbbVie: Carson:Flatiron Health: Employment; Washington University St. Louis: Roche: Consultancy.