Multiple Myeloma Clinical Trial
Official title:
Effects of Injection Tinzaparin Prophylactic Dose (4,500 IU Anti-Xa) on Thrombin Generation in Patients With Multiple Myeloma, Lymphoma Patients and Patients Hospitalized for an Acute Medical Condition.
In cancer, the incidence of venous thromboembolism (VTE) is particularly high in patients
with myeloma, especially when it is de novo and treated with thalidomide, lenalidomide or
erythropoietin. Curiously, the prevention of VTE with LMWH (low-molecular-weight heparin) in
myeloma seems no more effective than that achieved with aspirin, while the effectiveness of
the latter in the primary prevention of VTE has never been demonstrated regardless of the
type of population considered. Meanwhile, a biological study showed that prophylactic doses
of LMWH in patients with different types of cancer did not always optimal reduction of
thrombin peak during the 24 hours following the injection of LMWH. These clinical and
biological studies lead to the conclusion that patients with myeloma may be resistant to the
usual doses of preventive LMWH, which may explain the failure of prevention.
Initially we intend to investigate whether this resistance to prophylactic doses of LMWH is
present in patient's biology and if this resistance is specific to myeloma in hematological
cancers. For this, we propose to study the evolution of thrombin generation by
Thrombinography during 24 hours after subcutaneous injection of 4500 anti-Xa IU Tinzaparin
in 6 patients with de novo myeloma whit high thrombo embolic risk ie treated with
thalidomide, lenalidomide or erythropoietin. LMWH is Tinzaparin chosen because it does not
accumulate in patients with impaired renal function, and has a greater anti-biological
activity thrombotic than other LMWH.
To assess whether the observed pattern of thrombin generation is particularly multiple
myeloma, we will take the same study in 6 patients with aggressive lymphoma and 6 medical
patients hospitalized for acute heart and respiratory failure.
n/a
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