Prevention and Management of Venous Thromboembolic Events in Patients With Multiple Myeloma

Anticoagulation Regimen Use unfractionated heparin or LMWH at a prophylactic dose for as long as the patient is on therapy

Patient With Renal Failure Use full-dose warfarin

Patient With a History of VTE If > 1 VTE evaluate for a possible thrombophilia; in more difficult cases seek a multidisciplinary consult

Bortezomib-based (IMiD-less) Regimens No need for prophylaxis unless there are additional risk factors

Relapse Setting Prophylaxis for Patients on Pomalidomide-based Therapy

IMiD-only Regimens No prophylaxis or use low-dose aspirin

Patient on IMiD-based Regimen Who Develops a DVT or PE Continue or stop therapy while increasing level of anticoagulation?

Patient Who Develops a Catheter-related Thrombosis Interrupt therapy while the patient is appropriately managed, then resume therapy

Patients on IMiDs The risk for thrombosis is greatest during the first few months of therapy

Patients on IMiDs Need for routine screening in the absence of symptoms