Trial reportBlood2022
Prophylactic tranexamic acid in patients with hematologic malignancy: a placebo-controlled, randomized clinical trial.
Trial report in Blood, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 46 citations in OpenAlex.
- The efficacy of prophylactic tranexamic acid in patients with hematologic malignancy: a systematic review and meta-analysis.International journal of hematology · 2026Pooled it
- Red Blood Cells and Tranexamic Acid in the Inhibition of Fibrinolysis.Seminars in thrombosis and hemostasis · 2026Review
- Functional Aspects of Fibrin Structure Alterations by Tranexamic Acid in the Inhibition of Fibrinolysis.Biomolecules · 2026Article
- Considerations for Menstrual Suppression in Patients With Hematologic Malignancies.Pharmacotherapy · 2026Review
- The evolving landscape of platelet therapy: risks, innovations, and clinical judgment.Annals of hematology · 2026Review
- Cell-dependent antithrombotic effect of tranexamic acid.Frontiers in immunology · 2026Article
- Article
- Anticoagulant therapy in patients with cancer and thrombocytopenia.Journal of thrombosis and thrombolysis · 2025Review
- Safety and efficacy of tranexamic acid in oncologic surgery for spinal metastases: A systematic review.North American Spine Society journal · 2025Review
- Real World Management of Cytopenias and Infections in Patients With Myelofibrosis Treated With Ruxolitinib.EJHaem · 2025Article
- Article
- Fewer severe infections with tranexamic acid in patients with hematologic malignancies.Research and practice in thrombosis and haemostasis · 2024Article
- How to manage ITP with life-threatening bleeding.Hematology. American Society of Hematology. Education Program · 2023Review
- Platelet transfusions and predictors of bleeding in patients with myelodysplastic syndromes.European journal of haematology · 2023Article
- Machine Learning Predicts 30-Day Outcome among Acute Myeloid Leukemia Patients: A Single-Center, Retrospective, Cohort Study.Journal of clinical medicine · 2023Article
- Tranexamic acid for haemostasis and beyond: does dose matter?Thrombosis journal · 2023Review
- Prophylaxis with low dose tranexamic acid in acute myeloid leukemia patients undergoing intensive chemotherapy.EJHaem · 2023Article
- Absence of hyperfibrinolysis may explain lack of efficacy of tranexamic acid in hypoproliferative thrombocytopenia.Blood advances · 2023Article
- Evidence-Based Minireview: Strategies to manage a severely HLA-alloimmunized patient with refractory thrombocytopenia.Hematology. American Society of Hematology. Education Program · 2022Article
- The effect of ε-aminocaproic acid on blood product requirement, outcome and thromboelastography parameters in severely thrombocytopenic dogs.Journal of veterinary internal medicineArticle
Corrections and comments
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Authors and funding
13 authors at 5 institutions in 1 country.
Funding
Abstract
Evidence of the effectiveness of prophylactic use of tranexamic acid (TXA) in thrombocytopenia is lacking. To determine whether TXA safely reduces bleeding incidence in patients undergoing treatment for hematologic malignancies, a randomized, double-blind clinical trial was conducted from June 2016 through June 2020. Of 3120 screened adults, 356 patients were eligible and enrolled, and 337 patients (mean age, 53.9; 141 [41.8%] women), randomized to 1300 mg TXA orally or 1000 mg TXA through IV (n = 168) vs placebo (n = 169) thrice daily for maximum 30 days. Three hundred thirty patients were activated when their platelet counts fell below 30 000 per µL; 279 (83%) had complete outcome ascertainment. World Health Organization (WHO) grade ≥2 bleeding was observed in the 30 days following activation in 50.3% (73/145) and 54.2% (78/144) of patients in the TXA and placebo groups, with an adjusted odds ratio of 0.83 (95% confidence interval [CI], 0.50-1.34; P = .44). There was no statistically significant difference in the mean number of platelet transfusions (mean difference, 0.1; 95% CI, -1.9 to 2.0), mean days alive without grade ≥2 bleeding (mean difference, 0.8; 95% CI, -0.4 to 2.0), thrombotic events (6/163 [3.7%] TXA, 9/163 [5.5%] placebo), or deaths due to serious bleeding. Most common adverse events were: diarrhea (116/164 [70.7%] TXA and 114/163 [69.9%] placebo); febrile neutropenia (111/164 [67.7%] TXA, 105/163 [64.4%] placebo); fatigue (106/164 [64.6%] TXA, 109/163 [66.9%] placebo); and nausea (104/164 [63.4%] TXA, 97/163 [59.5%] placebo). Among patients with hematologic malignancy undergoing chemotherapy or hematopoietic stem cell transplantation, prophylactic treatment with TXA compared with placebo did not significantly reduce the risk of WHO grade ≥2 bleeding.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.