Retrospective Analysis of Epsilon-Amino-Caproic Acid (EACA) Therapy in Patients with Hypoproliferative Thrombocytopenia
Year: 2017
Type: article
Study design: Observational Study
Abstract: Bleeding still contributes to significant morbidity and mortality in patients with hypoproliferative thrombocytopenia even with optimal platelet transfusion support.We hypothesized that Epsilon-amino-caproic acid (EACA) therapy might stabilize a hemostatic plug thereby reducing bleeding in these patients.Over six years at our hospital, data from 133 patients with hematologic malignancies were retrospectively analyzed for three days prior to and for up to seven days after starting EACA therapy.Ninety-nine of these patients (74%) had active bleeding and with EACA therapy, bleeding decreased in 66%, was unchanged in 26% and increased in 8%.Even in the 45 patients with severe bleeding (WHO Grades 3 or 4), 62% showed bleeding improvement and in 6 with intra-cerebral bleeding, 3 improved and 3 stabilized.In the remaining 34 patients treated prophylactically (26%), usually because of refractoriness to platelet transfusions, 91% had no bleeding and 9% had only WHO Grade 1 bleeding.Among all treated patients, platelet and red cell transfusions decreased significantly by 0.25 and 0.24 units transfused/patient/day (p<0.003 and p<0.001 respectively) compared to blood product requirements before EACA therapy.These data suggest that EACA therapy may be a useful adjuvant to treat or prevent bleeding in thrombocytopenic patients.
Author: Terry Gernsheimer
Institution: University of Washington
Language: English
Subfield: Biochemistry (medical)
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2581626307