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Does Low-Molecular-Weight Heparin Influence the Antimyeloma Effects of Thalidomide? A Retrospective Analysis of Data from the GIMEMA, Nordic and Turkish Myeloma Study Groups

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Author

  • Meral Beksac
  • Anders Waage
  • Sara Bringhen
  • Sigurdur Y. Kristinsson
  • Gulsan Turkoz Sucak
  • Peter Gimsing
  • Giulia Lupparelli
  • Tulin Firatli-Tuglular
  • Gunnar Juliusson
  • Ingemar Turesson
  • Antonio Palumbo
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Summary, in English

Background/Aim: Low-molecular-weight heparin (LMWH) has been shown to prolong survival among patients with solid tumors, but its role among myeloma patients is unknown. Patients: Data from the GIMEMA (Gruppo Italiano Malattie Ematologiche dell'Adulto), Nordic and Turkish myeloma study groups comparing melphalan and prednisolone with (MPT, n: 404) or without thalidomide (MP, n: 393) are analyzed for effects of LMWH. Forty percent (159/394) of the patients on MPT and 7.4% (29/390) in the MP arm received LMWH. Results: Thalidomide improved response and progression-free survival (PFS). Regardless of thalidomide treatment, response rate was higher among those receiving LMWH vs. none vs. other anticoagulants (58.1 vs. 44.9 vs. 50.4%, p = 0.01). PFS was significantly longer (median 32 vs. 21 and 17 vs. 17 months, p = 0.004) only among international scoring system (ISS) I patients receiving MPT +/- LMWH vs. MP +/- LMWH. The group of MPT patients who also received LMWH had a better OS compared to those who did not [45 months, 95% confidence interval (CI) 27.7-62.3, vs. 32 months, 95% CI 26.1-37.9; p = 0.034]. When multivariate analysis was repeated in subgroups, thalidomide was no longer a significant factor (response, PFS) among those receiving LMWH. Conclusion: Addition of LMWH to MPT, in particular in patients with low ISS, suggests additive effects, but the results are limited by the retrospective design of our study. (C) 2015 S. Karger AG, Basel

Department/s

Publishing year

2015

Language

English

Pages

372-380

Publication/Series

Acta Haematologica

Volume

133

Issue

4

Document type

Journal article

Publisher

Karger

Topic

  • Hematology

Keywords

  • Anticoagulation
  • Heparin
  • Low-molecular-weight heparin
  • Multiple
  • myeloma
  • Thalidomide

Status

Published

ISBN/ISSN/Other

  • ISSN: 1421-9662