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Epsilon aminocaproic acid prevents bleeding in severely thrombocytopenic patients with hematological malignancies
Author(s) -
Antun Ana G.,
Gleason Shan,
Arellano Martha,
Langston Amelia A.,
McLemore Morgan L.,
Gaddh Manila,
el Rassi Fuad,
BernalMizrachi Leon,
Galipeau Jacques,
Heffner Leonard T.,
Winton Elliott F.,
Khoury Hanna J.
Publication year - 2013
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.28253
Subject(s) - medicine , platelet , thrombocytopenic purpura , bleed , surgery , aminocaproic acid , gastroenterology , platelet transfusion , antifibrinolytic , anesthesia , tranexamic acid , blood loss
BACKGROUND Despite prophylactic platelet transfusions, bleeding remains a significant problem in thrombocytopenic patients. METHODS The antifibrinolytic agent epsilon aminocaproic acid (EACA) was administered to 44 chronically (median duration, 273 days) and severely (platelet count, 8 × 10 9 /L; range, 1 × 10 9 /L‐ 19 × 10 9 /L) thrombocytopenic patients with hematological malignancies. Prophylactic EACA at a dose of 1 g twice daily was orally administered for a median duration of 47 days (range, 7 days‐209 days) until the platelet count recovered to > 30; × 10 9 /L. Platelets were only transfused if bleeding occurred. RESULTS While receiving EACA, 59% of the patients did not bleed, 25% had 19 episodes of spontaneously resolving minor bleeding that did not require platelet transfusion, and 16% received a median of 4 platelet transfusions (range, 1 transfusion‐8 transfusions) for 1 major traumatic and 9 spontaneous grade 2 to grade 3 bleeding (based on the World Health Organization classification of idiopathic thrombocytopenic purpura). No EACA toxicities were noted, and venous thromboses were not observed. CONCLUSIONS EACA is well tolerated and is associated with a low risk of major bleeding in patients with hematological malignancies who are experiencing chronic severe thrombocytopenia. Cancer 2013;119:3784–3787. © 2013 American Cancer Society.