Prevention and treatment of venous thromboembolism in patients with multiple myeloma: Clinical practice guidelines on behalf of the European Myeloma Network

Hemasphere. 2025 Aug 26;9(8):e70177. doi: 10.1002/hem3.70177. eCollection 2025 Aug.

Abstract

Venous thromboembolism (VTE) is a frequent complication in patients with multiple myeloma (MM) that leads to increased morbidity, mortality, treatment interruptions, and reduced quality of life. Αn Expert Panel Consensus Guideline on behalf of the European Myeloma Network provides evidence-based recommendations for VTE prevention and treatment in patients with MM. Key recommendations include the following: Patient education. Informing patients about VTE risk and signs/symptoms of deep vein thrombosis and pulmonary embolism. Specialized care. Establishing a dedicated diagnostic and therapeutic pathway for the prevention and treatment of VTE that occurs in an outpatient setting. Risk assessment. Regular evaluation of VTE risk using validated scores. Primary thromboprophylaxis. Initiating pharmacological thromboprophylaxis with low-molecular-weight heparin (LMWH) or specific direct factor Xa inhibitors (anti-Xa agents) in high-risk patients. Prompt diagnosis and treatment. Early diagnosis of VTE and immediate initiation of antithrombotic therapy with LMWH or anti-Xa agents. Secondary prophylaxis. Personalized long-term antithrombotic therapy based on individual profiles of risk of VTE recurrence or bleeding. By implementing these guidelines, healthcare providers can improve the prevention and treatment of VTE in patients with MM, leading to better clinical outcomes and quality of life.