Bleeding outcomes in thrombocytopenic acute leukemic patients with venous thromboembolism
Abstract Cancer‐associated thrombosis in acute leukemia patients with severe thrombocytopenia (platelets ≤50 × 109/L) poses a management challenge due to competing risks of bleeding and recurrent thrombosis. A retrospective analysis was conducted to determine the occurrence of clinically relevant bl...
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| Format: | Article |
| Language: | English |
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Wiley
2020-11-01
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| Series: | eJHaem |
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| Online Access: | https://doi.org/10.1002/jha2.90 |
| _version_ | 1797740000519913472 |
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| author | Nathaniel R. Wilson Maliha Khan Travis M. Cox Mohammed Nassif Wei Qiao Naveen Garg Fleur M. Aung Thein Hlaing Oo Cristhiam M. Rojas‐Hernandez |
| author_facet | Nathaniel R. Wilson Maliha Khan Travis M. Cox Mohammed Nassif Wei Qiao Naveen Garg Fleur M. Aung Thein Hlaing Oo Cristhiam M. Rojas‐Hernandez |
| author_sort | Nathaniel R. Wilson |
| collection | DOAJ |
| description | Abstract Cancer‐associated thrombosis in acute leukemia patients with severe thrombocytopenia (platelets ≤50 × 109/L) poses a management challenge due to competing risks of bleeding and recurrent thrombosis. A retrospective analysis was conducted to determine the occurrence of clinically relevant bleeding (CRB) rates during treatment for acute venous thromboembolic events (VTE) in thrombocytopenic acute leukemic patients. A cohort of 74 patients were subgrouped into three VTE‐treatment interventions: anticoagulation (n = 24), inferior vena cava filter placement (n = 22), and observation (n = 28). Multivariate analysis found a significant correlation between CRB occurrence and quantity of overall blood transfusions, chemotherapy administration, and relapsed leukemia presentation. There was no difference in the occurrence of CRB between VTE‐treatment subgroups, regardless of initial platelet count at the time of VTE diagnosis. Regarding the hematologic parameters, only the velocity of the platelet count recovery was associated with the risk of bleeding. From this analysis, it appears the trajectory of the platelet count and the factors associated with a slower recovery of it, are the main determinants for the occurrence of hemorrhagic complications during VTE treatment in acute leukemia. |
| first_indexed | 2024-03-12T14:06:14Z |
| format | Article |
| id | doaj.art-ee7c8d6a072c4870a9c31d356a648b30 |
| institution | Directory Open Access Journal |
| issn | 2688-6146 |
| language | English |
| last_indexed | 2024-03-12T14:06:14Z |
| publishDate | 2020-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | eJHaem |
| spelling | doaj.art-ee7c8d6a072c4870a9c31d356a648b302023-08-21T14:10:56ZengWileyeJHaem2688-61462020-11-011244845610.1002/jha2.90Bleeding outcomes in thrombocytopenic acute leukemic patients with venous thromboembolismNathaniel R. Wilson0Maliha Khan1Travis M. Cox2Mohammed Nassif3Wei Qiao4Naveen Garg5Fleur M. Aung6Thein Hlaing Oo7Cristhiam M. Rojas‐Hernandez8Department of Internal Medicine The University of Texas Health Science Center at Houston Houston TexasDepartment of Hematology and Oncology The University of Arkansas for Medical Sciences Little Rock ArkansasDepartment of Hematology and Oncology The University of Texas Health Science Center San Antonio San Antonio TexasDepartment of Pediatrics – Research Resource Office Baylor College of Medicine Houston TexasDepartment of Biostatistics The University of Texas M.D. Anderson Cancer Center Houston TexasDepartment of Diagnostic Radiology The University of Texas M.D. Anderson Cancer Center Houston TexasDepartment of Laboratory Medicine The University of Texas M.D. Anderson Cancer Center Houston TexasSection of Benign Hematology The University of Texas M.D. Anderson Cancer Center Houston TexasSection of Benign Hematology The University of Texas M.D. Anderson Cancer Center Houston TexasAbstract Cancer‐associated thrombosis in acute leukemia patients with severe thrombocytopenia (platelets ≤50 × 109/L) poses a management challenge due to competing risks of bleeding and recurrent thrombosis. A retrospective analysis was conducted to determine the occurrence of clinically relevant bleeding (CRB) rates during treatment for acute venous thromboembolic events (VTE) in thrombocytopenic acute leukemic patients. A cohort of 74 patients were subgrouped into three VTE‐treatment interventions: anticoagulation (n = 24), inferior vena cava filter placement (n = 22), and observation (n = 28). Multivariate analysis found a significant correlation between CRB occurrence and quantity of overall blood transfusions, chemotherapy administration, and relapsed leukemia presentation. There was no difference in the occurrence of CRB between VTE‐treatment subgroups, regardless of initial platelet count at the time of VTE diagnosis. Regarding the hematologic parameters, only the velocity of the platelet count recovery was associated with the risk of bleeding. From this analysis, it appears the trajectory of the platelet count and the factors associated with a slower recovery of it, are the main determinants for the occurrence of hemorrhagic complications during VTE treatment in acute leukemia.https://doi.org/10.1002/jha2.90acute leukemiaanticoagulationcancerplatelet countthrombocytopeniathrombosis |
| spellingShingle | Nathaniel R. Wilson Maliha Khan Travis M. Cox Mohammed Nassif Wei Qiao Naveen Garg Fleur M. Aung Thein Hlaing Oo Cristhiam M. Rojas‐Hernandez Bleeding outcomes in thrombocytopenic acute leukemic patients with venous thromboembolism eJHaem acute leukemia anticoagulation cancer platelet count thrombocytopenia thrombosis |
| title | Bleeding outcomes in thrombocytopenic acute leukemic patients with venous thromboembolism |
| title_full | Bleeding outcomes in thrombocytopenic acute leukemic patients with venous thromboembolism |
| title_fullStr | Bleeding outcomes in thrombocytopenic acute leukemic patients with venous thromboembolism |
| title_full_unstemmed | Bleeding outcomes in thrombocytopenic acute leukemic patients with venous thromboembolism |
| title_short | Bleeding outcomes in thrombocytopenic acute leukemic patients with venous thromboembolism |
| title_sort | bleeding outcomes in thrombocytopenic acute leukemic patients with venous thromboembolism |
| topic | acute leukemia anticoagulation cancer platelet count thrombocytopenia thrombosis |
| url | https://doi.org/10.1002/jha2.90 |
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