Shpilberg O, Blumenthal R, Sofer O, Katz Y, Chetrit A, Ramot B, Eldor A, Ben-Bassat I
Institute of Hematology, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
Leuk Lymphoma. 1995 Sep;19(1-2):141-4. doi: 10.3109/10428199509059668.
In order to determine the efficacy of the antifibrinolytic agent tranexamic acid (TA) in reducing bleeding and platelet transfusions during the treatment of acute myeloid leukemia (AML), we conducted a randomized placebo-controlled double-blind study. Patients with AML undergoing induction or postremission consolidation chemotherapy were randomized into TA or placebo groups. Patients were not given platelet transfusions prophylactically but only when bleeding occurred. The severity of any bleeding event was scored. Thirty eight patients were randomized during induction. There were no significant differences between the two groups in the number of bleeding events and their severity or in the number of platelet transfusions given. Eighteen patients were studied during consolidation. In contrast, to the induction period, during consolidation there was a significantly less severe bleeding tendency in the TA group resulting in a lower platelet transfusion requirement [3.7 +/- 4.1 vs. 9.3 +/- 3.3 platelet units (p < .05)]. TA was well tolerated and no side effects were seen and no specific thromboembolic events were noticed. We conclude that giving TA during the thrombocytopenic period of AML patients undergoing consolidation chemotherapy is beneficial and safely reduces platelet transfusions.
为了确定抗纤维蛋白溶解剂氨甲环酸（TA）在治疗急性髓系白血病（AML）期间减少出血和血小板输注方面的疗效，我们进行了一项随机安慰剂对照双盲研究。接受诱导或缓解后巩固化疗的AML患者被随机分为TA组或安慰剂组。患者不进行预防性血小板输注，仅在出血发生时进行输注。对任何出血事件的严重程度进行评分。38例患者在诱导期被随机分组。两组在出血事件的数量及其严重程度或血小板输注数量方面均无显著差异。18例患者在巩固期接受研究。与诱导期相比，在巩固期TA组的出血倾向明显较轻，导致血小板输注需求较低[3.7±4.1对9.3±3.3个血小板单位（p<0.05）]。TA耐受性良好，未见副作用，也未发现特定的血栓栓塞事件。我们得出结论，在接受巩固化疗的AML患者血小板减少期给予TA是有益的，并且能安全地减少血小板输注。
