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Updated: Feb 1, 2026

An Organotypic High Throughput System for Characterization of Drug Sensitivity of Primary Multiple Myeloma Cells
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Primary thromboembolic prevention in multiple myeloma patients: An exploratory meta-analysis on aspirin use

Giacomo Zoppellaro1, Nicola Veronese2, Serena Granziera3

  • 1Cardiology Clinic, Department of Cardiologic, Thoracic and Vascular Sciences, University of Padua, Italy.

Seminars in Hematology
|December 4, 2018
PubMed
Abstract

Insights

Acetylsalicylic acid (ASA) effectively prevents venous thromboembolism (VTE) in multiple myeloma (MM) patients compared to no treatment. More research is needed to determine if low-molecular weight heparins (LMWH) offer superior VTE prevention over ASA.

Area of Science:

  • Hematology
  • Oncology
  • Pharmacology

Background:

  • Multiple myeloma (MM) is a hematological malignancy.
  • Venous thromboembolism (VTE) is a common complication in MM patients, particularly during treatment with immunomodulatory drugs.
  • The optimal antithrombotic strategy for VTE prophylaxis in MM remains debated, with differing guidelines on acetylsalicylic acid (ASA) versus low-molecular weight heparins (LMWH).

Purpose of the Study:

  • To systematically review and conduct a meta-analysis comparing ASA with other interventions for VTE prophylaxis in MM patients.
  • To evaluate the efficacy of ASA in preventing VTE in the context of MM treatment.

Main Methods:

  • An exploratory meta-analysis and systematic review of studies comparing ASA to no intervention or LMWH for VTE prophylaxis in MM.
  • Included 10 studies (2 RCTs, 6 longitudinal, 2 retrospective) with 1,964 participants.

Main Results:

  • ASA significantly reduced VTE risk compared to no intervention (OR=0.20; 95%CI: 0.07-0.61).
  • Longitudinal studies suggested a higher VTE risk with ASA compared to LMWH (OR=2.60; 95%CI: 1.08-6.25).
  • No significant differences in VTE risk were observed between ASA and LMWH in randomized controlled trials.

Conclusions:

  • ASA demonstrates good efficacy in VTE prevention compared to no intervention in MM patients.
  • Current data are insufficient to establish LMWH superiority over ASA for VTE prophylaxis in MM.
  • Further large-scale, well-powered trials are necessary to definitively establish the optimal antithrombotic strategy.
Keywords:
aspirinlow molecular weight heparinsmultiple myelomathromboprophylaxisvenous thromboembolism

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