Venous Thromboembolism Risk in Patients With Newly Diagnosed Multiple Myeloma Treated with Carfilzomib or Bortezomib in Combination With Lenalidomide and Dexamethasone

This retrospective study aimed to explore risk of venous thromboembolism in patients with newly diagnosed multiple myeloma treated with the regimen carfilzomib, lenalidomide, and dexamethasone (KRd) compared to bortezomib, lenalidomide, and dexamethasone (VRd). Contrary to previous reports, induction with a carfilzomib-based regimen was not associated with an increased risk of venous thromboembolism in this 209patient cohort.Background: Multiple myeloma (MM), as well as some treatments for MM, increase the risk of venous thromboembolism (VTE). Prior literature suggests carfilzomib, lenalidomide, and dexamethasone (KRd) may have a higher incidence of thromboembolic events compared with bortezomib, lenalidomide, and dexamethasone (VRd). We aimed to evaluate VTE risk with KRd induction compared to VRd at a large academic medical center in the United States. Materials and Methods: We retrospectively reviewed patients with newly diagnosed MM presenting at a single institution. Patients were followed for objectively diagnosed VTE events for 6 months following the start of induction therapy.Results: A total of 209 patients were included, with 69 (33%) receiving KRd and 140 (67%) receiving VRd. Overall, 18 patients (9%) had a VTE event, with 5 (7%) in the KRd cohort and 13 (9%) in the VRd cohort ( P = .80). Treatment with KRd was not associated with an increased risk of VTE compared to VRd (HR 0.74; 95% CI 0.26-2.08; P = .57).Conclusion: In this cohort, KRd was not associated with an increase in VTE risk compared to VRd, contrary to prior literature.