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Sydney 2005:
Thalidomide and Cardiovascular Complications in MM
By Maurizio Zangari, MD
Dr. Zangari followed Dr. Weber and provided an overview of the early uses of thalidomide and its teratogenic effects. Dr. Zangari pointed out that the success of thalidomide with leprosy led to the initiation of clinical trials in oncology. Research in these areas demonstrated a possible association of thalidomide with thromboembolism. Because incidence was low, several trials with thalidomide in combination with existing agents have been investigated for the newly-diagnosed patient with MM. Incidence of thrombosis with thalidomide has been observed to occur in early treatment with thalidomide and there is a higher incidence with newly diagnosed patients compared with relapsing patients. Dr. Zangari reviewed studies that compared prophylactic low- weight-molecular heparin, warfarin, and aspirin with thalidomide-based therapies suggesting that there may be a reduction of thrombosis with prophylactic therapy. Another complication seen in trials with thalidomide is the observation of sinus bradycardia. Similar to the management of thromboembolism, prophylactic use of anticoagulants is recommended for cardiovascular complications.

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