RGD Reference Report - Inflammation, TNFalpha and endothelial dysfunction link lenalidomide to venous thrombosis in chronic lymphocytic leukemia. - Rat Genome Database

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Inflammation, TNFalpha and endothelial dysfunction link lenalidomide to venous thrombosis in chronic lymphocytic leukemia.

Authors: Aue, G  Nelson Lozier, J  Tian, X  Cullinane, AM  Soto, S  Samsel, L  McCoy, P  Wiestner, A 
Citation: Aue G, etal., Am J Hematol. 2011 Oct;86(10):835-40. doi: 10.1002/ajh.22114. Epub 2011 Aug 2.
RGD ID: 5685033
Pubmed: PMID:21812019   (View Abstract at PubMed)
PMCID: PMC3414537   (View Article at PubMed Central)
DOI: DOI:10.1002/ajh.22114   (Journal Full-text)

Patients receiving lenalidomide are at an increased risk for deep venous thrombosis (DVT). Here, we prospectively investigated the DVT risk in patients with relapsed chronic lymphocytic leukemia (CLL) treated with lenalidomide (n = 32). Five patients developed six incidents of DVT over 1 year for an annual incidence of 16%. Three of these were considered drug-related. Median time to DVT was 105 days (range 56-259 days). No pulmonary embolism was detected. Hypercoagulability screen before study entry was negative in all patients who subsequently developed DVTs. Compared to normal volunteers CLL patients had increased baseline levels of D-dimer, thrombin-antithrombin, soluble vascular endothelial adhesion molecule 1 (sVCAM-1), and thrombomodulin (p < 0.001). After 1 week on lenalidomide D-dimer, thrombomodulin, sVCAM-1, factor VIII, TNFalpha, and C-reactive protein were significantly increased while protein C was decreased (p < 0.001). In patients with lenalidomide-related DVTs, TNFalpha, and sVCAM-1 were more strongly upregulated than in all other patients (p < 0.05) and TNFalpha and sVCAM-1 levels were significantly correlated (r = 0.65, p < 0.001). These data link lenalidomide associated DVTs with TNFalpha upregulation and endothelial cell dysfunction and suggest that aspirin may have a role for DVT prophylaxis in these patients.

RGD Manual Disease Annotations    Click to see Annotation Detail View
TermQualifierEvidenceWithReferenceNotesSourceOriginal Reference(s)
B-Cell Chronic Lymphocytic Leukemia  IEP 5685033 RGD 
B-Cell Chronic Lymphocytic Leukemia  ISOTHBD (Homo sapiens)5685033; 5685033 RGD 

Objects Annotated

Genes (Rattus norvegicus)
Thbd  (thrombomodulin)

Genes (Mus musculus)
Thbd  (thrombomodulin)

Genes (Homo sapiens)
THBD  (thrombomodulin)


Additional Information