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多发性骨髓瘤(MM)患者静脉血栓栓塞(VTE)的危险性增加(发生率约为3%~10%),接受沙利度胺或雷利度胺治疗时此种危险性进一步增加。VTE增加的危险因素有年龄、肥胖、VTE病史、中心静脉插管、合并疾病(感染、糖尿病和心血管病)、手术和遗传性易栓症,以及与高剂量地塞米松、多柔比星、红细胞生成素合用或多药联合化疗。VTE一般在开始治疗后的6个月内发生。研究表明,应用沙利度胺或雷利度胺治疗时采取预防血栓措施可降低VTE的发生率。预防方法为:低危患者使用阿司匹林;高危患者应使用低分子量肝素(LMWH)或足量华法林;接受高剂量地塞米松或多柔比星以及多药化疗患者,应使用LMWH或足量华法林进行预防,一般为4~6个月。
Patients with multiple myeloma (MM) have an increased risk of venous thromboembolism (VTE) of about 3% to 10%, and this risk is further increased with thalidomide or lenalidomide. Risk factors for increased VTE include age, obesity, a history of VTE, central venous catheterization, comorbidities (infections, diabetes and cardiovascular disease), surgical and genetic thrombolysis, and high-dose dexamethasone, doxorubicin , Erythropoietin or multi-drug combination chemotherapy. VTE generally occurs within 6 months after starting treatment. Studies have shown that the use of thalidomide or lenalidomide therapy to prevent thrombosis measures can reduce the incidence of VTE. Prevention is as follows: low-risk patients using aspirin; high-risk patients should use low molecular weight heparin (LMWH) or sufficient warfarin; high-dose dexamethasone or doxorubicin and multi-drug chemotherapy patients should use LMWH or sufficient Warfarin for prevention, usually 4 to 6 months.