The use of antifibrinolytics in pediatric patients with hypoproliferative thrombocytopenia

Delaney, Meghan; Matthews, Dana C.; Gernsheimer, Terry

doi:10.1002/pbc.26641

Cited by 2 publications

(3 citation statements)

References 22 publications

(46 reference statements)

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“…Antifibrinolytics have reduced bleeding rates and blood transfusions for patients with hypoproliferative thrombocytopenia due to chemotherapy. 25 They have also been used successfully with patients with immune and nonimmune thrombocytopenia. 26,27 For patients with factor VII deficiency, antifibrinolytics are used to control mucocutaneous bleeding or are used before surgery as monotherapy or in combination with factor replacement.…”

Section: Discussionmentioning

confidence: 99%

“…We have used antifibrinolytic agents to treat children with various bleeding disorders, consistent with what has been reported in the literature. Antifibrinolytics have reduced bleeding rates and blood transfusions for patients with hypoproliferative thrombocytopenia due to chemotherapy 25 . They have also been used successfully with patients with immune and nonimmune thrombocytopenia 26,27 .…”

Section: Discussionmentioning

confidence: 99%

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Use of crushed tranexamic acid tablets in water for paediatric patients with bleeding disorders

Al‐Huniti,

Marshall,

Rusk

et al. 2024

Haemophilia

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BackgroundΕ‐Aminocaproic acid oral solution (EACA OS) is the only commercially available antifibrinolytic for patients who cannot swallow tablets. Insurance denials and high costs remain barriers to its use.ObjectivesTo determine the safety and efficacy of crushed tranexamic acid tablets in water (cTXAw) for children with bleeding disorders.MethodsWe retrospectively reviewed records of children (<10 years) with bleeding disorders who received cTXAw or EACA OS from 1 December 2018, through 31 July 2022, at Mayo Clinic (Rochester, Minnesota). Bleeding outcomes were defined according to ISTH criteria.ResultsThirty‐two patients were included (median age, 3 years; male, n = 23). Diagnoses were VWD (n = 17), haemophilia (n = 5), FVII deficiency (n = 3), inherited platelet disorder (n = 4), ITP (n = 2), and combined FV and FVII deficiencies (n = 1). Thirty‐two courses of cTXAw (monotherapy 24/32; mean duration 6 days) and fifteen courses of EACA (monotherapy 12/15; mean duration 5 days) were administered. No surgical procedures (n = 28) were complicated by bleeding. Of the 19 bleeding events, 16 had effective haemostasis, two had no reported outcome, and one had no response. cTXAw and EACA were equally effective in preventing and treating bleeding (p value > .1). No patients had adverse effects. Eight of 19 patients (42%) who were initially prescribed EACA OS did not receive it because of cost or insurance denial.The estimated average wholesale price of one treatment was $94 for cTXAw and $905 for EACA OS.ConclusionsCTXAw appears to be an effective, safe, and low‐cost alternative option to EACA OS for young children with bleeding disorders.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Use of crushed tranexamic acid tablets in water for paediatric patients with bleeding disorders

Al‐Huniti,

Marshall,

Rusk

et al. 2024

Haemophilia

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“…Anti brinolytic drugs have been widely used in obstetrics and gynecology surgery, cardiac surgery, trauma, hip and knee replacement and other elds to reduce perioperative bleeding and blood transfusion [1]. Among them, tranexamic acid (TXA) is the most common type used in surgery, and its main mechanism has been deeply studied.…”

Section: Introductionmentioning

confidence: 99%

Hemostatic Effect and Safety of TXA: An Umbrella Review

Jiang

Deng

Liu

et al. 2020

Preprint

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Aim To evaluate the hemostatic effect and safety of tranexamic acid (TXA). Methods Meta-analyses were retrieved from databases. Risk ratios (RR), odds ratios (OR), weighted mean difference (WMD), standard mean difference (SMD) and 95% confidence intervals (CI) were extracted to compare the effeteness of TXA in reducing TBL, transfusion rate, Hb drop, mortality, DVT, PE. Results In total, 136 trials (396 comparisons) including 17 kinds of surgeries were retrieved. The evidence for TXA using in total knee arthroplasty (TKA), total hip arthroplasty (THA), postpartum bleeding, intertrochanteric fractures, orthopaedic surgery, spinal surgery, shoulder arthroplasty, hip fracture surgery, cardiac surgery, menstrual bleeding, plastic surgery, myomectomy, nasal surgery was assessed as possible for the association of reducing TBL. The evidence for TXA using in TKA, THA, postpartum bleeding, orthopaedic surgery, shoulder arthroplasty was assessed as probable for the association of reducing transfusion rate. The evidence for TXA using in liver surgery, spinal surgery, hip fracture surgery, cancer, cardiac surgery was considered to be possible for the association of reducing transfusion rate. The evidence for TXA using in intertrochanteric fractures, orthopaedic surgery, hip fracture surgery was assessed as probable for the association of reducing Hb drop. The evidence for TXA using in TKA, THA, postpartum bleeding, shoulder arthroplasty was considered to be possible for the association of reducing Hb drop. The evidence for TXA using in trauma, gastrointestinal bleeding was assessed as probable for the association of reducing mortality. Conclusion This umbrella review indicated that TXA were regarded as effective to reduce TBL, transfusion rate, Hb drop, mortality, and did not increase the incidence of DVT and PE. However, more convincing evidence should be provided to further clarify the level of efficacy and safety of TXA.

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The use of antifibrinolytics in pediatric patients with hypoproliferative thrombocytopenia

Cited by 2 publications

References 22 publications

Use of crushed tranexamic acid tablets in water for paediatric patients with bleeding disorders

Use of crushed tranexamic acid tablets in water for paediatric patients with bleeding disorders

Hemostatic Effect and Safety of TXA: An Umbrella Review

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