Use of platelet transfusions and tranexamic acid in patients with myelodysplastic syndromes: A clinical practice survey.

Abstract

AIM:

Thrombocytopenia and bleeding are common in myelodysplastic syndromes (MDS), but optimal management is unknown. We conducted a survey to identify current clinical practice regarding platelet transfusion (PLT-T) and tranexamic acid (TXA) to inform future trial design.

METHOD:

A 25-question survey was distributed to members of the ALLG from December 2020 to July 2021.

RESULTS:

Sixty-four clinicians across Australia, New Zealand and Singapore responded. Clinicians treated a median of 15 MDS patients annually. Twenty-nine (45%) reported having institutional guidelines regarding prophylactic PLT-T. Although 60 (94%) said they would consider using TXA, most (58/64; 91%) did not have institutional guidelines. Clinical scenarios showed prophylactic PLT-T was more likely administered for patients on disease-modifying therapy (49/64; 76%, commonest threshold <10 × 109 /L) or with minor bleeding (32/64 [50%] transfusing at threshold <20 × 109 /L, 23/64 [35%] at <10 × 109 /L). For stable untreated patients, 29/64 (45%) would not give PLT-T and 32/64 (50%) would. Most respondents (46/64; 72%) were interested in participating in trials in this area. Potential barriers included resource limitations, funding and patient/clinician acceptance.

CONCLUSION:

Real-world management of MDS-related thrombocytopenia varies and there is a need for clinical trials to inform practice.

• Authors: Allison Mo, Robert Weinkove, Erica M Wood, Jake Shortt, Anna Johnston, Zoe K McQuilten, Australasian Leukaemia and Lymphoma Group Supportive Care Scientific Working Party
• Journal: European journal of haematology (Eur J Haematol) Vol. 112 Issue 4 Pg. 621-626 (Apr 2024) ISSN: 1600-0609 [Electronic] England
• PMID: 38123137 (Publication Type: Journal Article)
• Copyright: © 2023 The Authors. European Journal of Haematology published by John Wiley & Sons Ltd.

Chemical References

• Tranexamic Acid

Topics

• Humans
• Tranexamic Acid (therapeutic use)
• Platelet Transfusion (adverse effects)
• Hemorrhage (therapy, drug therapy)
• Thrombocytopenia (therapy, drug therapy)
• Myelodysplastic Syndromes (drug therapy)