What is your approach for using anticoagulation/aspirin in patients with multiple myeloma?

Excellent question with lots of nuances but no clear answer. I'll start with my gestalt approach, which is to consider a DOAC for every patient with myeloma if all of the following are true:

1. They are receiving an IMiD (lenalidomide or pomalidomide)
2. They set off my 'spidey sense' with one or more of ...

@Dr. First Last has done a wonderful job here.

My practice is to start a prophylactic dose DOAC (apixaban 2.5 mg BID, rivaroxaban 10 mg daily) for essentially all patients with newly diagnosed myeloma. This is in part because we frequently employ quadruplets and/or cafilzomib-based regimens. I tran...