GRP-024 Antithrombotic Prophylaxis in Patients with Multiple Myeloma Being Treated with Lenalidomide

Background The diagnosis of multiple myeloma (MM) has been associated with a greater risk of thromboembolic events. At the same time, the treatment with lenalidomide, an immunomodulator authorised in 2007 by the EMA, causes a significant increase in the risk of deep vein and arterial thrombosis, and pulmonary embolism in patients with MM. Purpose To find whether patients diagnosed with MM being treated with lenalidomide have prophylactic antithrombotic treatment with low molecular weight heparin or with acenocoumarol, as recommended in the ASCO (American Society of Clinical Oncology) guidelines. Materials and Methods A retrospective observational study was carried out in a 700-bed secondary hospital from January 2011 to February 2012. The patients included had MM and lenalidomide and dexamethasone treatment and picked up their medicines in our hospital. The data were obtained from a Diraya computer system of the Andalusian health system. The following data were obtained: sex, age, whether they had anticoagulant treatment or not and if they had, what type of anticoagulation they received. Results The total number of patients was 31, 16 males and 15 females, with an average age of 61.7 years. Of these 31 patients treated with lenalidomide plus dexamethasone, only 9 patients received antithrombotic prophylactic treatment. Of the 22 who did not receive it, there were two cases of episodes of deep arterial thrombosis. Conclusions Most of the patients with multiple myeloma who come to our pharmacy service are without antithrombotic prophylactic treatment with the risk that this situation entails. As pharmacists we consider it necessary to remind haematologists of the necessity both of prescribing such treatment in order to avoid future complications, and of monitoring that these recommendations are observed, in order to guarantee the safe use of lenalidomide. No conflict of interest.