Tranexamic Acid Does Not Reduce Bleeding in Patients With Hematological Malignancies Undergoing Chemotherapy
December 09, 2024
Treatment with tranexamic acid (TXA) does not reduce bleeding incidence in patients with hematological malignancies undergoing intensive chemotherapy, according to findings published in
The Lancet Haematology.
In the phase 3 TREATT trial, investigators randomized patients undergoing intensive chemotherapy or hematopoietic stem-cell transplantation (with platelet counts below 10 × 10⁹ per liter for 5 days or more) to receive either TXA or a placebo when platelet counts dropped below 30 × 10⁹ per L. Treatment was continued until platelet recovery or day 30, with prophylactic platelet transfusions maintained as standard care.
Among 597 patients included in the intention-to-treat analysis, there was no significant difference in the primary endpoint: 31.7% of patients in the TXA group and 34.2% in the placebo group experienced WHO grade 2 or higher bleeding or mortality by day 30. Serious adverse events and thrombotic complications were also similar between the two groups.
According to the authors, the findings suggest that TXA does not offer sufficient benefit to justify its routine use for bleeding prevention in this patient population.
