A CONTROLLED TRIAL OF TRANEXAMIC ACID THERAPY FOR THE REDUCTION OF BLEEDING DURING TREATMENT OF ACUTE MYELOID-LEUKEMIA

order to determine the efficacy of the antifibrinolytic agent tranexam ic 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 in duction or postremission consolidation chemotherapy were randomized in to 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 duri ng induction. There were no significant differences between the two gr oups in the number of bleeding events and their severity or in the num ber of platelet transfusions given. Eighteen patients were studied dur ing consolidation. In contrast, to the induction period, during consol idation 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 tolerate d and no side effects were seen and no specific thromboembolic events were noticed. We conclude that giving TA during the thrombocytopenic p eriod of AML patients undergoing consolidation chemotherapy is benefic ial and safely reduces platelet transfusions.