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Bleeding outcomes in thrombocytopenic acute leukemic patients with venous thromboembolism

Cancer‐associated thrombosis in acute leukemia patients with severe thrombocytopenia (platelets ≤50 × 10(9)/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...

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Autores principales: Wilson, Nathaniel R., Khan, Maliha, Cox, Travis M., Nassif, Mohammed, Qiao, Wei, Garg, Naveen, Aung, Fleur M., Oo, Thein Hlaing, Rojas‐Hernandez, Cristhiam M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9175819/
https://www.ncbi.nlm.nih.gov/pubmed/35845011
http://dx.doi.org/10.1002/jha2.90
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author Wilson, Nathaniel R.
Khan, Maliha
Cox, Travis M.
Nassif, Mohammed
Qiao, Wei
Garg, Naveen
Aung, Fleur M.
Oo, Thein Hlaing
Rojas‐Hernandez, Cristhiam M.
author_facet Wilson, Nathaniel R.
Khan, Maliha
Cox, Travis M.
Nassif, Mohammed
Qiao, Wei
Garg, Naveen
Aung, Fleur M.
Oo, Thein Hlaing
Rojas‐Hernandez, Cristhiam M.
author_sort Wilson, Nathaniel R.
collection PubMed
description Cancer‐associated thrombosis in acute leukemia patients with severe thrombocytopenia (platelets ≤50 × 10(9)/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.
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spelling pubmed-91758192022-07-14 Bleeding outcomes in thrombocytopenic acute leukemic patients with venous thromboembolism Wilson, Nathaniel R. Khan, Maliha Cox, Travis M. Nassif, Mohammed Qiao, Wei Garg, Naveen Aung, Fleur M. Oo, Thein Hlaing Rojas‐Hernandez, Cristhiam M. EJHaem Sickle Cell, Thrombosis, and Haematology Cancer‐associated thrombosis in acute leukemia patients with severe thrombocytopenia (platelets ≤50 × 10(9)/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. John Wiley and Sons Inc. 2020-09-02 /pmc/articles/PMC9175819/ /pubmed/35845011 http://dx.doi.org/10.1002/jha2.90 Text en © 2020 The Authors. eJHaem published by British Society for Haematology and John Wiley & Sons Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Sickle Cell, Thrombosis, and Haematology
Wilson, Nathaniel R.
Khan, Maliha
Cox, Travis M.
Nassif, Mohammed
Qiao, Wei
Garg, Naveen
Aung, Fleur M.
Oo, Thein Hlaing
Rojas‐Hernandez, Cristhiam M.
Bleeding outcomes in thrombocytopenic acute leukemic patients with venous thromboembolism
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 Sickle Cell, Thrombosis, and Haematology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9175819/
https://www.ncbi.nlm.nih.gov/pubmed/35845011
http://dx.doi.org/10.1002/jha2.90
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