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. Author manuscript; available in PMC: 2020 May 1.
Published in final edited form as: Crit Rev Oncol Hematol. 2019 Feb 27;137:18–26. doi: 10.1016/j.critrevonc.2019.02.011

Table 3:

Recommendation for VTE prophylaxis in MM patients on Immunomodulator drugs (IMiDs)

Risk factors (RF) Recommended Therapy
Individual RFa

Myeloma-associated RFb 		NCCN, 2018 EMN, 2015
No or only one risk factor
Aspirin 81 to 325 mg/d Aspirin 100 mg/d
≥ 2 risk factors
LMWH
or
Warfarind 		LWMH (Switch to aspirin after 4 months)
or
Warfarin
IMiD based regimensc LMWH
or
Warfarind 		LWMH (Switch to aspirin after 4 months)
or
Warfarin

Abbreviations: EMN=European Myeloma Network; IMiD= Immunomodulator drugs; LMWH= low molecular weight heparin; MM=multiple myeloma; NCCN=National Comprehensive Cancer Network; RF=risk factor.

a

Individual risk factors are described in the text.

b

Myeloma associated risk factors include diagnosis of myeloma and hyperviscosity.

c

Immunomodulator drugs (lenalidomide, pomalidomide, thalidomide) in combination with dexamethasone (>480 mg/month), doxorubicin or combination chemotherapy.

d

Target INR 2-3.