ToolsCalculators
IMPEDE-VTE
Estimates venous thromboembolism risk in patients with multiple myeloma starting chemotherapy.
IMPEDE-VTE
Immunomodulatory drug (thalidomide, lenalidomide, or pomalidomide) as part of current therapy
BMI ≥25 kg/m²
Recent pathological pelvic, hip, or femur fracture
Erythropoiesis-stimulating agent
Doxorubicin as part of current therapy
Dexamethasone dose
Asian or Pacific Islander race/ethnicity
History of VTE
Tunneled line or central venous catheter
Current thromboprophylaxis
Result0 points
Low risk of VTE (approximately 3.3 % at 6 months in the derivation cohort).
- 6-month VTE incidence (derivation cohort)
- 3.3 %
When to use
- Assessing VTE risk in patients with multiple myeloma before or during chemotherapy.
- Selecting patients who may benefit most from pharmacologic thromboprophylaxis.
Formula
Points: IMiD +4, BMI ≥25 +1, recent pelvic/hip/femur fracture +4, erythropoiesis-stimulating agent +1, doxorubicin +3, dexamethasone (low-dose +2 / high-dose +4), Asian/Pacific Islander race −3, prior VTE +5, tunneled line/central venous catheter +2, prophylactic aspirin −3 or therapeutic anticoagulation −4. Risk: ≤3 low, 4-7 intermediate, ≥8 high.
Pearls and pitfalls
- Outperformed prior IMWG/NCCN qualitative guidance for VTE risk discrimination in the derivation and validation cohorts.
- A negative total score is possible and simply reflects a low-risk patient (e.g. established therapeutic anticoagulation).