Should you consider thromboprophylaxis, even for low-dose lenalidomide maintenance, post-autologous transplantation?

In the event there are no adverse contraindications for the use of thromboprophylaxis, yes, I recommend the use of a minimum of 81 mg of aspirin daily with a low dose of lenalidomide. In this meta-analysis (Chakraborty et al., PMID 31913498), the risk of venous thromboembolism was low with a low dose of lenalidomide. The use of dexamethasone with lenalidomide increased the risk of venous thromboembolism. That said, they concluded that lenalidomide-based regimens have a notable risk of thromboembolism, supporting the use of thromboprophylaxis in patients being treated with lenalidomide. Other studies have evaluated the use of thromboprophylaxis in various settings, such as newly diagnosed and relapsed disease settings. In my opinion, the dat...