Key takeaways
- Multiple myeloma can increase your risk of developing blood clots because the condition itself can lead to increased inflammation and “stickier” blood.
- Certain medications used to treat multiple myeloma, such as lenalidomide, thalidomide, and pomalidomide, can significantly elevate the risk of blood clots.
- Preventing and managing blood clots involves various strategies, including lifestyle adjustments like staying active and hydrated and medical interventions such as blood thinners or aspirin.
Blood clots are gel-like masses that form when blood clumps together. If you are hurt and bleeding, they can help stop bleeding. But blood clots that break loose and get stuck in another blood vessel can block blood flow. Depending where it is, this can be a medical emergency.
If you’re living with multiple myeloma, you may have been told that you’re at an increased risk of developing blood clots, but effective treatment is available. While there is no single treatment that works for everyone, your doctor will choose the best match for you.
The technical term for a blood clot is “venous thromboembolism (VTE),” which includes both deep vein thrombosis (DVT) and pulmonary embolism (PE). A DVT requires prompt medical attention. When a blood clot travels to the lungs, it causes a PE, which is also a serious condition requiring immediate medical attention.
Multiple myeloma, a type of cancer that occurs when atypical plasma cells develop in the bone marrow and quickly reproduce, may increase the risk of blood clots. Additionally, some medications used to treat this health condition may increase that risk, especially in the first 6 months after diagnosis.
“An increased risk of blood clots may be related to the increased levels of inflammation in multiple myeloma,” said Shaji K. Kumar, MD, a hematologist and internist at Mayo Clinical Comprehensive Cancer Center and Chair of the NCCN Clinical Practice Guidelines in Oncology Panel for multiple myeloma.
People with multiple myeloma may have “stickier” blood that is more prone to form clots, he said. And they may be less mobile due to bone pain or to fractures secondary to multiple myeloma.
Some of the medications used to treat multiple myeloma may increase the risk of a blood clot. For instance, lenalidomide, thalidomide, and pomalidomide are all known to increase the blood clot risk.
“The mechanisms are not fully understood, though damage from the drug to the lining of the blood vessels may be one reason,” said Kumar.
A history of blood clots or being immobilized due to a fracture, bone pain, or surgery, as well as certain types of chemotherapy drugs, all may increase your risk of a blood clot with multiple myeloma.
In people with multiple myeloma, the most common blood clots are those involving the large veins in the lower extremities of the body, such as the hips and legs, said Kumar. In fact, people with a new diagnosis of multiple myeloma have a 10 to 20 times higher risk of VTE than other people.
A VTE is a blood clot that forms within a deep vein, often in the leg or pelvis. A small number of people may develop a PE.
A blood clot does not always cause symptoms, but you should be aware of the common symptoms that may occur. These vary depending on where the clot is.
If you have a blood clot in your arm or leg, you will have pain, redness, swelling, and warmth. This is especially a concern if it is in only one arm or leg.
A blood clot in your lungs (PE) may cause a fast or irregular heartbeat, trouble breathing, sweating, fever, and a feeling of panic and may cause you to cough up blood. A person with a PE may also experience low blood pressure and chest pain, said Kumar.
A clot in the brain may cause headache, dizziness, blurred vision, facial drooping, leg or arm weakness, and difficulty speaking or slurred speech.
There are various ways to prevent and manage blood clots, from lifestyle changes to medications.
Your doctor may prescribe an anticoagulant (blood thinner), which is a medication that thins your blood and can decrease the risk of a blood clot. You may take a blood thinner orally (by mouth) or receive it as an injection. Alternatively, they may recommend that you take aspirin during multiple myeloma treatment.
In one clinical trial, researchers are studying direct oral anticoagulants to see whether newer oral blood thinners such as apixaban and rivaroxaban could safely replace injections. If this is the case, it could mean fewer injections, a lower risk of clotting, and a better quality of life.
This research focuses on how to predict who is likely to develop a blood clot so that treatment can be started.
Medications called
To help decrease your risk of a blood clot, your doctor may advise you to stay active and drink plenty of water.
Other helpful strategies include:
- avoiding smoking and other tobacco use
- avoiding crossing your legs, which can block blood flow and damage your veins over time
- wearing compression stockings
- getting up to stretch every
1 or 2 hours if you spend a lot of time sitting - stretching and bending your knees, legs, and ankles every 1 or 2 hours if you cannot get up
It’s important to be aware of the signs and symptoms of a blood clot and to discuss any concerns with your doctor. You should seek immediate medical help if you experience chest pain or breathing problems or if you have a swollen, painful leg.
Multiple myeloma may cause your blood to become “stickier” and more likely to form clots. Certain medications used to treat the disease can increase your risk of blood clots, as can a decrease in mobility that may result from the effects of the disease.
Blood clots do not always cause symptoms, but when they do, symptoms may include:
- pain, swelling, and warmth in one arm or leg
- sweating, difficulty breathing, and chest pain
- dizziness, facial drooping, or slurred speech
It’s important to seek medication attention right away if you think you have any symptoms of a blood clot.
You can reduce your risk of clots by drinking plenty of water, staying active, and avoiding crossing your legs and using tobacco products.