Development and validation of a new risk assessment model for immunomodulatory drug-associated venous thrombosis among Chinese patients with multiple myeloma,Thrombosis Journal

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Development and validation of a new risk assessment model for immunomodulatory drug-associated venous thrombosis among Chinese patients with multiple myeloma
Thrombosis Journal ( IF 3.1 ) Pub Date : 2023-10-04 , DOI: 10.1186/s12959-023-00534-y
Xiaozhe Li ₁ , Xiuli Sun ₂ , Baijun Fang ₃ , Yun Leng ₄ , Fangfang Sun ₂ , Yaomei Wang ₃ , Qing Wang ₅ , Jie Jin ₆ , Min Yang ₆ , Bing Xu ₇ , Zhihong Fang ₇ , Lijuan Chen ₈ , Zhi Chen ₈ , Qimei Yang ₉ , Kejie Zhang ₁₀ , Yinhai Ye ₁₀ , Hui Geng ₁₁ , Zhiqiang Sun ₁₂ , Dan Hao ₁₂ , Hongming Huang ₁₃ , Xiaotao Wang ₁₄ , Hongmei Jing ₁₅ , Lan Ma ₁₅ , Xueyi Pan ₁₆ , Wenming Chen ₄ , Juan Li ₁

Affiliation

Department of Haematology, First Affiliated Hospital of Sun Yat-sen University, No. 58 Zhongshan Er Road, Guangzhou, 510000, Guangdong, China.
Department of Haematology, First Affiliated Hospital of Dalian Medical University, Dalian, China.
Department of Haematology, Henan Cancer Hospital, Zhengzhou, China.
Department of Haematology, Beijing Chaoyang Hospital, Beijing, China.
Department of Haematology, Guizhou Provincial People's Hospital, Guiyang, China.
Department of Haematology, First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
Department of Haematology, First Affiliated Hospital of Xiamen University, Xiamen, China.
Department of Haematology, Jiangsu Provincial People's Hospital, Nanjing, China.
Department of Haematology, Shantou Central Hospital, Shantou, China.
Department of Haematology, Zhongshan Hospital Affiliated to Xiamen University, Xiamen, China.
Department of Haematology, Affiliated Hospital of Qinghai University, Xining, China.
Department of Haematology, Shenzhen Hospital of Southern Medical University, Shenzhen, China.
Department of Haematology, Nantong University Hospital, Nantong, China.
Department of Haematology, Second Affiliated Hospital of Guilin Medical College, Guilin, China.
Department of Haematology, Peking University Third Hospital, Beijing, China.
Department of Haematology, First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China.

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. 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. 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. The new RAM outperformed the IMWG guidelines and the SAVED score and could potentially guide the VTE prophylaxis strategy for Chinese MM patients.

更新日期：2023-10-05

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