Thromb Haemost 2013; 110(04): 844-851
DOI: 10.1160/TH13-02-0140
New Technologies, Diagnostic Tools and Drugs
Schattauer GmbH

MELISSE, a large multicentric observational study to determine risk factors of venous thromboembolism in patients with multiple myeloma treated with immunomodulatory drugs

Xavier Leleu
1   Hospital Huriez, department Maladies du Sang, CHRU Lille, France
,
Philippe Rodon
3   Hospital of Blois, CH Blois, France
,
Cyrille Hulin
4   Hospital Brabois, CHU Vandoeuvre les Nancy, France
,
Laurent Daley
2   LEO Pharma, Voisins-Le-Bretonneux France
,
Charles Dauriac
5   Hospital Pontchaillou, CHU Rennes, France
,
Maya Hacini
6   Hospital Chambery, CH Chambery, France
,
Olivier Decaux
7   Hospital sud, CHU Rennes, France
,
Jean-Claude Eisemann
8   Hospital E. Muller, CH Mulhouse, France
,
Olivier Fitoussi
9   Polyclinique Bordeaux Aquitaine, Bordeaux, France
,
Bruno Lioure
10   Hospital de Hautepierre, CHU Strasbourg, France
,
Laurent Voillat
11   Hospital W. Morey, CH Chalon sur Saone, France
,
Borhane Slama
12   Hospital H. Duffaut, CH Avignon, France
,
Ahmad Al Jijakli
13   Hospital of Argenteuil, CH Argenteuil, France
,
Riad Benramdane
14   Hospital Dubos, CH Cergy-Pontoise, France
,
Carinne Chaleteix
15   Hospital Estaing, CHU Clermont-Ferrand, France
,
Régis Costello
16   Hospital nord, CHU Marseille, France
,
Antoine Thyss
17   Centre Antoine Lacassagne, Nice, France
,
Claire Mathiot
18   Institut Curie, Paris, France
,
Boyle Eileen
1   Hospital Huriez, department Maladies du Sang, CHRU Lille, France
,
Frédéric Maloisel
19   Clinique Ste Anne, Strasbourg, France
,
Anne-Marie Stoppa
20   Institut Paoli Calmette, Marseille, France
,
Brigitte Kolb
21   Hospital Debré, CHU Reims, France
,
Mauricette Michallet
22   Hospital Edouard Herriot, CHU Lyon, France
,
Anne Lamblin
2   LEO Pharma, Voisins-Le-Bretonneux France
,
Patrick Natta
2   LEO Pharma, Voisins-Le-Bretonneux France
,
Thierry Facon
1   Hospital Huriez, department Maladies du Sang, CHRU Lille, France
,
Ismail Elalamy
23   Hospital Tenon, APHP Paris, France
,
Jean-Paul Fermand
24   Hospital Saint Louis, APHP Paris, France
,
Philippe Moreau
25   Hospital Hotel Dieu, CHU Nantes, France
› Author Affiliations
Further Information

Publication History

Received: 19 February 2013

Accepted after major revision: 22 June 2013

Publication Date:
01 December 2017 (online)

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Summary

Immunomodulatory drugs (IMiDs) are associated with an increased risk of venous thromboembolism (VTE) in multiple myeloma (MM) patients. We designed MELISSE, a multicentre prospective observational study, to evaluate VTE incidence and identify risk factors in IMiDstreated MM. Our objective was to determine the real-life practice of VTE prophylaxis strategy. A total of 524 MM patients were included, and we planned to collect information at baseline, at four and at 12 months, on MM therapy, on VTE risk factors and management. VTE incidence was 7% (n=31), including 2.5% pulmonary embolism (PE) (n=11), similar at four or 12 months. VTE was observed at all risk assessment levels, although the increased risk assessment level correlated to a lower rate of VTE, maybe due to the implemented thromboprophylaxis strategy. VTE occurred in 7% on aspirin vs 3% on lowmolecular- weight heparin (LMWH) prophylaxis, and none on vitamin K antagonists (VKA). New risk factors for VTE in IMiDs-treated MM were identified. In conclusion, VTE prophylaxis is compulsory in IMiDstreated MM, based on individualised VTE risk assessment. Anticoagulation prophylaxis with LMWH should clearly be prioritised in MM patients with high VTE risk, along with VKA. Further prospective studies will identify most relevant VTE risk factors in IMiDs-treated MM to select accurately which MM patients should receive LMWH prophylaxis and for which duration to optimise VTE risk reduction.