Abstract

Patients with multiple myeloma are at an increased risk of venous thromboembolism and arterial thrombosis. We assessed the impact of venous and arterial thrombosis on survival in a population-based study of 9,399 multiple myeloma patients diagnosed in Sweden from 1987 to 2005. We found multiple myeloma patients with venous thromboembolism to have a higher mortality at 1-, 5-, and 10-years of follow up compared with those without, with hazard ratios of 2.9 (95% confidence interval (CI) 2.4-3.5), 1.6 (95% CI: 1.5-1.8), and 1.6 (95% CI: 1.4-1.7), respectively.

There was an increase in risk of death among multiple myeloma patients with arterial thrombosis, with hazard ratios of 3.4 (95% CI: 3.0-3.8), 2.2 (95% CI: 2.0-2.3), and 2.1 (95% CI: 1.9-2.1), respectively. In landmark analyses at six months, early arterial but not venous thromboembolism was associated with a higher risk of death.

Thus, in contrast to prior smaller studies, we found the development of thrombosis to be associated with significantly poorer survival. The prevention of thrombosis in multiple myeloma is an important goal in the management of these patients.

On my connecting flight back from Atlanta last night, I sat next to a surgical pathology resident named Monica.  Her father had died from multiple myeloma many years earlier, after undergoing an auto stem cell transplant.

She felt that he never fully recovered from the full-body radiation he received to help destroy his bone marrow.  Thank God our fellow patients are not forced to endure that today!

Later in the conversation, she recommended I start wearing elastic compression socks during my flights.  GREAT ADVICE!  I’m on blood thinners, but I’m also still taking Revlimid–and blood clots are common in patients using this drug.

I’m going to head-down to my neighborhood CVS Pharmacy and pick-up a pair before my early morning flight tomorrow.

Feel good and keep smiling!  Pat