Lisa Baumann Kreuziger, MD, MS
Lisa Baumann Kreuziger, MD, MS, Associate Professor of Hematology/Oncology at Versiti/Medical College of Wisconsin, Milwaukee, introduced Terry B. Gernsheimer, MD, at the Plenary Session and spoke with The ASCO Post about the results of the study.
“The investigators of the A-TREAT trial tested a very specific indication and showed us that the use of tranexamic acid for the prevention of bleeding in patients with hematologic malignancies and low platelet counts is not beneficial. It did not prevent bleeding nor change the number of transfusions patients received,” she said.
Echoing Dr. Gernsheimer, Dr. Kreuziger expressed surprise at the findings. “This was something we thought would be useful, given the potential mechanism of action (impairment of fibrinolysis) and the fact that it’s been used successfully in several other indications, such as in orthopedic surgery,” she said. “The good part is that the study was definitive,” she concluded. “The curves overlapped, and there was no subgroup in which tranexamic acid was better.”
The findings are likely to be extrapolated to the use of aminocaproic acid, which has a similar mechanism of action, Dr. Kreuziger added. Although the two agents are often used interchangeably in clinical practice, aminocaproic acid has a burdensome dosing schedule and has not been favored.
Finally, the study by Dr. Gernsheimer and colleagues clearly negates the prophylactic use of tranexamic acid; however, it does not resolve the question of its value in patients who are bleeding. In that treatment setting, therefore, use of the drug can still be considered to be justified, Dr. Kreuziger maintained.
DISCLOSURE: Dr. Baumann Kreuziger reported no conflicts of interest.
In the first randomized trial to evaluate prophylactic antifibrinolytic therapy in patients with hematologic malignancies, tranexamic acid failed to reduce bleeding or the need for transfusion vs placebo. The study was featured as a Plenary Session during the 2020 American Society of Hematology...