2016
DOI: 10.1002/14651858.cd009733.pub3
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Antifibrinolytics (lysine analogues) for the prevention of bleeding in people with haematological disorders

Abstract: Background People with haematological disorders are frequently at risk of severe or life-threatening bleeding as a result of thrombocytopenia (reduced platelet count). This is despite the routine use of prophylactic platelet transfusions to prevent bleeding once the platelet count falls below a certain threshold. Platelet transfusions are not without risk and adverse events may be life-threatening. A possible adjunct to prophylactic platelet transfusions is the use of antifibrinolytics, specifically the lysin… Show more

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Cited by 56 publications
(49 citation statements)
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References 69 publications
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“…Although there is concern regarding thrombotic complications due to TA , the drug has not been associated with an increased thromboembolic risk when used prophylactically in major paediatric surgery or during total knee arthroplasty . A similar finding was reported in the above mentioned Cochrane study .…”
Section: Discussionsupporting
confidence: 80%
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“…Although there is concern regarding thrombotic complications due to TA , the drug has not been associated with an increased thromboembolic risk when used prophylactically in major paediatric surgery or during total knee arthroplasty . A similar finding was reported in the above mentioned Cochrane study .…”
Section: Discussionsupporting
confidence: 80%
“…Most importantly, epsilon aminocaproic acid, the predecessor antifibrinolytic agent of TA, has been shown to prevent bleeding in severely thrombocytopenic patients with haematological malignancies . However, the result of a Cochrane review indicated that the evidence available for the use of antifibrinolytics in haematology is very limited .…”
Section: Discussionmentioning
confidence: 99%
“…A key question before considering alternatives to transfusion is whether prophylactic platelet transfusion is necessary at all. RCTs in ITP, haematological malignancy undergoing chemotherapy, MDS and liver disease Antifibrinolytics (Estcourt et al, 2016) In clinical use largely outside the setting of thrombocytopenia. (Afdhal et al (2014), Geissler et al (2003), Prica et al (2014), Zeng et al (2011) In clinical use in some types of thrombocytopenia.…”
Section: No Platelet Transfusionmentioning
confidence: 99%
“…This approach is appealing, as these agents are cheap and have been shown to be effective in a number of other patient settings (not necessarily characterised by thrombocytopenia, such as trauma) with minimal adverse events (Ker et al, 2012;Shakur et al, 2010). A recent systematic review focussing on the use of tranexamic acid in patients with haematological malignancies (Estcourt et al, 2016) identified three trials examining tranexamic acid and one trial examining epsilonaminocaproic acid, all of which were of low quality, and small sample size. A recent systematic review focussing on the use of tranexamic acid in patients with haematological malignancies (Estcourt et al, 2016) identified three trials examining tranexamic acid and one trial examining epsilonaminocaproic acid, all of which were of low quality, and small sample size.…”
Section: Antifibrinolytic Agentsmentioning
confidence: 99%
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