Hamostaseologie 2021; 41(S 01): S55
DOI: 10.1055/s-0041-1728212
Poster
Venous thromboembolism

International Myeloma Working Group (IMWG) score accuracy in multiple myeloma patients: need for action

L Papageorgiou
1   Thrombosis Center, Service d’Hématologie Biologique Hôpital Tenon, Hôpitaux Universitaires de l’Est Parisien, Assistance Publique Hôpitaux de Paris, Faculté de Médecine Sorbonne Université, Sorbonne University, Paris
2   Research Group “Cancer, Haemostasis and Angiogenesis”, INSERM U938, Centre de Recherche Saint-Antoine, Institut Universitaire de Cancérologie, Faculty of Medicine, Sorbonne University, Sorbonne University, Paris
,
P Vandreden
3   Clinical Research, Diagnostica Stago, Gennevilliers
2   Research Group “Cancer, Haemostasis and Angiogenesis”, INSERM U938, Centre de Recherche Saint-Antoine, Institut Universitaire de Cancérologie, Faculty of Medicine, Sorbonne University, Sorbonne University, Paris
,
L Garderet
4   Deparment of Clinical Hematology, Pitié-Salpetriere Hospital, Sorbonne University, Paris
5   Clinical Research Center, Saint-Antoine Hospital, Sorbonne University, Paris
,
I Elalamy
1   Thrombosis Center, Service d’Hématologie Biologique Hôpital Tenon, Hôpitaux Universitaires de l’Est Parisien, Assistance Publique Hôpitaux de Paris, Faculté de Médecine Sorbonne Université, Sorbonne University, Paris
2   Research Group “Cancer, Haemostasis and Angiogenesis”, INSERM U938, Centre de Recherche Saint-Antoine, Institut Universitaire de Cancérologie, Faculty of Medicine, Sorbonne University, Sorbonne University, Paris
,
G Gerotziafas
1   Thrombosis Center, Service d’Hématologie Biologique Hôpital Tenon, Hôpitaux Universitaires de l’Est Parisien, Assistance Publique Hôpitaux de Paris, Faculté de Médecine Sorbonne Université, Sorbonne University, Paris
2   Research Group “Cancer, Haemostasis and Angiogenesis”, INSERM U938, Centre de Recherche Saint-Antoine, Institut Universitaire de Cancérologie, Faculty of Medicine, Sorbonne University, Sorbonne University, Paris
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Objective Venous thromboembolism (VTE) remains a common complication in patients with multiple myeloma (MM) occurring at around 10% of cases. This challenging evolution can be optimized with a better identification of patients at risk and a more regular and tailored application of thromboprophylaxis strategy. IMWG guidelines recently proposed a risk-assessment model in order to establish these specific approaches in all IMID-receiving patients .

The aim was to evaluate the predictive strength of the current IMWG score in MM patients.

Material and Methods This is a monocentric, prospective, non-interventional study on a cohort of 93 consecutive MM patients referred to the Hemostasis Center at Tenon University Hospital. The IMWG score was calculated during the 1st visit and thrombotic prevention data were collected. The follow-up period was one year.

Results Among 93 patients with a male/female ratio of 40/53 and a median age of 65.7 years old, 57 patients (61%) were at low risk, (Group A) receiving aspirin in only 18 of cases. The other patients (39%) were stratified at high risk (Group B) receiving heparin thromboprophylaxis in 6 of cases and aspirin in 9 cases. Risk stratification was as follows: 22 patients with a score at 2, 8 patients at 3 and 2 patients at 4. Thrombosis occurred in 11 patients (12%): 7 in group A and 4 in group B. In Group A, 5 presented a symptomatic pulmonary embolism (PE), 1 with distal lower limb thrombosis and 1 with proximal lower limb thrombosis. In group B, 3 patients presented with a symptomatic PE and 1 with distal lower limb thrombophlebitis. These thrombotic events were not correlated with MM staging, treatment response and IMIDs treatment.

Conclusion Despite a systematic application of IMWG scoring and thromboprophylaxis strategy implementation, VTE occurrence remains significantly high in MM patients considered at low risk and heparin thromboprophylaxis regimen was not optimal with a remained incidence around 11%. These disappointing results require the development of more accurate risk assessment models based on a more selected clinical parameters in order to define more adapted thromboprophylaxis strategy based on more pertinent biological markers.



Publication History

Article published online:
18 June 2021

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