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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
- Publication Year :
- 2015
-
Abstract
- 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 dellʼAdulto), 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.
- Subjects :
- Male
Melphalan
medicine.medical_specialty
Turkey
medicine.drug_class
Low molecular weight heparin
Antineoplastic Agents
Kaplan-Meier Estimate
Gastroenterology
Disease-Free Survival
Anticoagulation
Drug Therapy
Multiple myeloma
Internal medicine
80 and over
medicine
Humans
Heparin
Low-molecular-weight heparin
Thalidomide
Aged
Aged, 80 and over
Anticoagulants
Drug Therapy, Combination
Female
Follow-Up Studies
Heparin, Low-Molecular-Weight
Middle Aged
Multiple Myeloma
Prednisone
Retrospective Studies
Treatment Outcome
Hematology
Medicine (all)
business.industry
Low-Molecular-Weight
Retrospective cohort study
General Medicine
medicine.disease
Confidence interval
Surgery
Combination
Prednisolone
business
medicine.drug
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....82ac17cab8b202598ab67d00ab756374