Multiple Myeloma Coverage from Every Angle

Predisposing Factors to Catheter-Related Thrombosis in Patients With Myeloma Undergoing ASCT

By: Celeste L. Dixon
Posted: Wednesday, January 5, 2022

A retrospective study spanning 10 years and 276 patients with multiple myeloma who underwent autologous stem cell transplantation (ASCT) found a “relatively low” incidence—2.5%—of symptomatic catheter-related thrombosis. Still, as Lidia Gil, MD, PhD, of Poznan University of Medical Sciences in Poznan, Poland, and colleagues described in Medicina, specific risk factors associated with the development of symptomatic catheter-related thrombosis in this patient population include the following:

  • Previous thrombotic events, especially during the induction of myeloma treatment;
  • Dehydration following gastrointestinal complications, such as vomiting and diarrhea;
  • Catheter-related infection;
  • Noninfectious complications.

The investigators noted that the incidence was low despite cancer-associated thrombosis being a common oncologic complication, particularly in patients with multiple myeloma, and despite the known risk of catheter-related thrombosis in transplant-eligible patients receiving standard-of-care ASCT. The patients in this cohort all had central venous catheters placed before ASCT between 2009 and 2019, and all were examined for clinical symptoms of catheter-related thrombosis: edema, redness, and pain in the catheter area. The diagnosis of the seven patients with catheter-related thrombosis (all but one case occurred during hospitalization) was confirmed with Doppler ultrasound examination.

Dr. Gil and co-investigators looked for associations between catheter-related thrombosis and many other variables, including age, gender, obesity, monoclonal protein type, and disease stage, and they found none of statistical significance. They emphasized, however, that “almost all patients [in this group had] achieved remission before ASCT, and 70% [had] achieved at least [a] very good partial response; thus, [the] patients with an optimal response to previous treatment [were the ones undergoing ASCT].”

Therefore, whether or not all patients with multiple myeloma who are undergoing ASCT should receive thromboprophylaxis remains an open question that should be addressed in prospective studies, the authors suggested.

Disclosure: The study authors reported no conflicts of interest.

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