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Blood Clots

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Here's a topic that's important to know about, even for those of you with MGUS:  BLOOD CLOTS. 

Myeloma, in and of itself, is a risk factor for a blood clot, known in med-speak as a deep vein thrombosis, or DVT.   Simply being over 65 is a risk factor for blood clots as well.  Blood clots can be life-threatening if they become dislodged, or embolize, from their original site (usually the lower leg) and enter the lungs.

Even people with MGUS (monoclonal gammopathy of undetermined significance) and smoldering (or asymptomatic) myeloma are at increased risk for blood clots, though at lower risk than those with active disease.  Add to this the increased risk of a blood clot posed by treatment with thalidomide or Revlimid, especially in combination with dexamethasone or chemotherapy, and the odds of having a DVT become even higher.  

The good news is that there is a system for evaluating risk in each patient based both on the factors mentioned above and the patient's own individual characteristics and medical history. Based upon that risk assessment, preventive strategies ranging from a daily baby aspirin for those with the lowest risk to strong blood thinners for those at greatest risk can be taken.

Every patient with MGUS, asymptomatic myeloma, or active myeloma should be evaluated by their hematologist/oncologist for their risk of developing a blood clot.   For further information, please see  the International Myeloma Working Group (IMWG) publication, "Prevention of thalidomide- and lenalidomide-associated thrombosis in myeloma," and the simplified IMWG Guidelines on this topic.

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