Epsilon aminocaproic acid prevents bleeding in severely thrombocytopenic patients with hematological malignancies.
BACKGROUND
Despite prophylactic platelet transfusions, bleeding remains a significant problem in thrombocytopenic patients.


METHODS
The antifibrinolytic agent epsilon aminocaproic acid (EACA) was administered to 44 chronically (median duration, 273 days) and severely (platelet count, 8 × 10(9)/L; range, 1 × 10(9)/L-19 × 10(9)/L) thrombocytopenic patients with hematological malignancies. Prophylactic EACA at a dose of 1 g twice daily was orally administered for a median duration of 47 days (range, 7 days-209 days) until the platelet count recovered to > 30; × 10(9) /L. Platelets were only transfused if bleeding occurred.


RESULTS
While receiving EACA, 59% of the patients did not bleed, 25% had 19 episodes of spontaneously resolving minor bleeding that did not require platelet transfusion, and 16% received a median of 4 platelet transfusions (range, 1 transfusion-8 transfusions) for 1 major traumatic and 9 spontaneous grade 2 to grade 3 bleeding (based on the World Health Organization classification of idiopathic thrombocytopenic purpura). No EACA toxicities were noted, and venous thromboses were not observed.


CONCLUSIONS
EACA is well tolerated and is associated with a low risk of major bleeding in patients with hematological malignancies who are experiencing chronic severe thrombocytopenia.
Department, of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Emory University School of Medicine, Atlanta, Georgia.
Ana G
AG
Antun
Shannon
S
Gleason
Martha
M
Arellano
Amelia A
AA
Langston
Morgan L
ML
McLemore
Manila
M
Gaddh
Fuad
F
el Rassi
Leon
L
Bernal-Mizrachi
Jacques
J
Galipeau
Leonard T
LT
Heffner
Elliott F
EF
Winton
Hanna J
HJ
Khoury
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015119:Aminocaproic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D000933:Antifibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data; D004334:Drug Administration Schedule; D005260:Female; D019337:Hematologic Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D006470:Hemorrhage / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D017713:Platelet Transfusion / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013921:Thrombocytopenia / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D055815:Young Adult
D000933:Antifibrinolytic Agents; D015119:Aminocaproic Acid
antifibrinolytic agent; bleeding; epsilon aminocaproic acid; hematologic malignancies; thrombocytopenia