Author:
Li Xiaozhe,Sun Xiuli,Fang Baijun,Leng Yun,Sun Fangfang,Wang Yaomei,Wang Qing,Jin Jie,Yang Min,Xu Bing,Fang Zhihong,Chen Lijuan,Chen Zhi,Yang Qimei,Zhang Kejie,Ye Yinhai,Geng Hui,Sun Zhiqiang,Hao Dan,Huang Hongming,Wang Xiaotao,Jing Hongmei,Ma Lan,Pan Xueyi,Chen Wenming,Li Juan
Abstract
Abstract
Background
Individuals with multiple myeloma (MM) receiving immunomodulatory drugs (IMiDs) are at risk of developing venous thromboembolism (VTE), a serious complication. There is no established clinical model for predicting VTE in the Chinese population. We develop a new risk assessment model (RAM) for IMiD-associated VTE in Chinese MM patients.
Methods
We retrospectively selected 1334 consecutive MM patients receiving IMiDs from 16 medical centers in China and classified them randomly into the derivation and validation cohorts. A multivariate Cox regression model was used for analysis.
Results
The overall incidence of IMiD-related VTE in Chinese MM patients was 6.1%. Independent predictive factors of VTE (diabetes, ECOG performance status, erythropoietin-stimulating agent use, dexamethasone use, and VTE history or family history of thrombosis) were identified and merged to develop the RAM. The model identified approximately 30% of the patients in each cohort at high risk for VTE. The hazard ratios (HRs) were 6.08 (P < 0.001) and 6.23 (P < 0.001) for the high-risk subcohort and the low-risk subcohort, respectively, within both the derivation and validation cohorts. The RAM achieved satisfactory discrimination with a C statistic of 0.64. The stratification approach of the IMWG guidelines yielded respective HRs of 1.77 (P = 0.053) and 1.81 (P = 0.063). The stratification approach of the SAVED score resulted in HRs of 3.23 (P = 0.248) and 1.65 (P = 0.622), respectively. The IMWG guideline and the SAVED score-based method yielded C statistics of 0.58 and 0.51, respectively.
Conclusions
The new RAM outperformed the IMWG guidelines and the SAVED score and could potentially guide the VTE prophylaxis strategy for Chinese MM patients.
Funder
Guangzhou Municipal Science and Technology Project
National Natural Science Foundation of China
5010 Clinical Research Project of Sun Yat-sen University
Guangdong Natural Science Foundation
Publisher
Springer Science and Business Media LLC