SEARCHCOHORThematology, oncology

cohort·hematology, oncology, internal medicine, clinical trial, observational study·PMC10552366

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

Thrombosis Journal · 26 authors, 16 centres

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A multivariate Cox regression model identified five independent predictive factors for VTE: diabetes, ECOG performance status, erythropoietin-stimulating agent use, dexamethasone use, and VTE or family history of thrombosis. The new risk assessment model (RAM) achieved a C statistic of 0.64, identifying about 30% of patients as high-risk with a hazard ratio of over 6.0 in both cohorts. This performance was superior to the IMWG guidelines (C statistic 0.58) and the SAVED score (C statistic 0.51). The study notes a low overall VTE incidence of 6.1% in this population and highlights that risk factors and prophylaxis practices differ from Western studies.

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hematology

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ORIGINAL PAPER

PMC10552366

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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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. Supplementary Information The online version contains supplementary material available at 10.1186/s12959-023-00534-y.

CITATION EXPORT

Xiaozhe Li, Xiuli Sun, Baijun Fang et al.. Development and validation of a new risk assessment model for immunomodulatory drug-associated venous thrombosis among Chinese patients with multiple myeloma. Thrombosis Journal. (2023). https://doi.org/10.1186/s12959-023-00534-y

AUTHORS

26 · 16 CENTRES

Xiaozhe Li, Xiuli Sun, Baijun Fang, Yun Leng, Fangfang Sun, Yaomei Wang, Qing Wang, Jie Jin, Min Yang, Bing Xu, Zhihong Fang, Lijuan Chen, Zhi Chen, Qimei Yang, Kejie Zhang, Yinhai Ye, Hui Geng, Zhiqiang Sun, Dan Hao, Hongming Huang, Xiaotao Wang, Hongmei Jing, Lan Ma, Xueyi Pan, Wenming Chen, Juan Li

1https://ror.org/037p24858grid.412615.5Department of Haematology, First Affiliated Hospital of Sun Yat-sen University, No. 58 Zhongshan Er Road, Guangzhou, 510000 Guangdong China
2https://ror.org/055w74b96grid.452435.10000 0004 1798 9070Department of Haematology, First Affiliated Hospital of Dalian Medical University, Dalian, China
3https://ror.org/043ek5g31grid.414008.90000 0004 1799 4638Department of Haematology, Henan Cancer Hospital, Zhengzhou, China
4https://ror.org/01eff5662grid.411607.5Department of Haematology, Beijing Chaoyang Hospital, Beijing, China
5https://ror.org/046q1bp69grid.459540.90000 0004 1791 4503Department of Haematology, Guizhou Provincial People’s Hospital, Guiyang, China
6https://ror.org/05m1p5x56grid.452661.20000 0004 1803 6319Department of Haematology, First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
7https://ror.org/0006swh35grid.412625.6Department of Haematology, First Affiliated Hospital of Xiamen University, Xiamen, China
8https://ror.org/01dspcb60grid.415002.20000 0004 1757 8108Department of Haematology, Jiangsu Provincial People’s Hospital, Nanjing, China
9https://ror.org/04jmrra88grid.452734.30000 0004 6068 0415Department of Haematology, Shantou Central Hospital, Shantou, China
10grid.12955.3a0000 0001 2264 7233Department of Haematology, Zhongshan Hospital Affiliated to Xiamen University, Xiamen, China
11grid.459333.bDepartment of Haematology, Affiliated Hospital of Qinghai University, Xining, China
12grid.488521.2Department of Haematology, Shenzhen Hospital of Southern Medical University, Shenzhen, China
13https://ror.org/02afcvw97grid.260483.b0000 0000 9530 8833Department of Haematology, Nantong University Hospital, Nantong, China
14https://ror.org/03cmqpr17grid.452806.d0000 0004 1758 1729Department of Haematology, Second Affiliated Hospital of Guilin Medical College, Guilin, China
15https://ror.org/04wwqze12grid.411642.40000 0004 0605 3760Department of Haematology, Peking University Third Hospital, Beijing, China
16https://ror.org/02gr42472grid.477976.c0000 0004 1758 4014Department of Haematology, First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China

Xiaozhe Li, Xiuli Sun, Baijun Fang et al.. Development and validation of a new risk assessment model for immunomodulatory drug-associated venous thrombosis among Chinese patients with multiple myeloma. Thrombosis Journal. (2023). https://doi.org/10.1186/s12959-023-00534-y