P969: COMPARISON OF VENOUS THROMBOEMBOLISM INCIDENCE IN MULTIPLE MYELOMA PATIENTS RECEIVING LENALIDOMIDE-BASED REGIMENS WITH RIVAROXABAN OR ASPIRIN THROMBOPROPHYLAXIS

Abstract

Background: Thromboprophylaxis is routinely used with lenalidomide-based regimens in multiple myeloma because of a substantial risk of venous thromboembolism (VTE). Aspirin is one of the most common thromboprophylaxis agent but also increases bleeding complications.Rivaroxaban represents a selective direct inhibitor of activated coagulation factor X (FXa) having peroral bioavailability and prompt onset of action which can mitigate the risk of higher incidence of VTE without an observable increase in bleeding rates.However, little is known about the incidence of VTE in lenalidomide-based regimens with rivaroxaban thromboprophylaxis. Aims: The purpose of our study was to compare of venous thromboembolism incidence in multiple myeloma patients receiving lenalidomide-based regimen with rivaroxaban or aspirin thromboprophylaxis. Methods: We conducted a single-centre retrospective study designed to assess the rates of VTE, including pulmonary embolism (PE) and deep vein thrombosis (DVT), in MM patients receiving lenalidomide-based regimen with aspirin or rivaroxaban thromboprophylaxis.A total of 130 patients who were not anticoagulated for other clinical indications and received at least 1 cycle of lenalidomide-based regimen between January 2015 and December 2021 were included. Clinical bleeding events after treatment were also important indicators in our study. Results: The incidence of venous thromboembolism in the rivaroxaban group was significantly lower than that in the aspirin prevention group (P<0.05). The incidence of bleeding in the rivaroxaban group was also lower than that in the aspirin prevention group,but there was no statistical significance(P﹥0.05). Table II. - Analysis of VTE and Bleeding. Regimen + prophylaxis R-based regimens+ASA（n=84） R-based regimens+XA（n=46） P-value VTE 13（15.5%） 1（2.2%） 0.041 Bleeding 6（7.1%） 0 0.081 ASA, aspirin; XA, rivaroxaban; VTE, venous thromboembolism. Image:Summary/Conclusion: In this pilot study, we found that rivaroxaban was safe and well-tolerated as the primary preventive measure for venous thromboembolism in patients with multiple myeloma receiving lenalidomide-based regimen. However, these findings warrant further investigation in a larger randomized study to be validated.