• Ana G Antun, Shannon Gleason, Martha Arellano, Amelia A Langston, Morgan L McLemore, Manila Gaddh, Fuad el Rassi, Leon Bernal-Mizrachi, Jacques Galipeau, Leonard T Heffner, Elliott F Winton, and Hanna J Khoury.
• Department, of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Emory University School of Medicine, Atlanta, Georgia.
• Cancer. 2013 Nov 1;119(21):3784-7.

BackgroundDespite prophylactic platelet transfusions, bleeding remains a significant problem in thrombocytopenic patients.MethodsThe 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.ResultsWhile 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.ConclusionsEACA is well tolerated and is associated with a low risk of major bleeding in patients with hematological malignancies who are experiencing chronic severe thrombocytopenia.© 2013 American Cancer Society.

40 keywords...

hide…