We thank Stacie Holloway, Marian Sheppard, Katharine Lord, and Brittany Hill for their support in monitoring patient compliance with epsilon aminocaproic acid therapy.
Epsilon aminocaproic acid prevents bleeding in severely thrombocytopenic patients with hematological malignancies
Article first published online: 6 AUG 2013
© 2013 American Cancer Society
Volume 119, Issue 21, pages 3784–3787, 1 November 2013
How to Cite
Antun, A. G., Gleason, S., Arellano, M., Langston, A. A., McLemore, M. L., Gaddh, M., el Rassi, F., Bernal-Mizrachi, L., Galipeau, J., Heffner, L. T., Winton, E. F. and Khoury, H. J. (2013), Epsilon aminocaproic acid prevents bleeding in severely thrombocytopenic patients with hematological malignancies. Cancer, 119: 3784–3787. doi: 10.1002/cncr.28253
- Issue published online: 18 OCT 2013
- Article first published online: 6 AUG 2013
- Manuscript Accepted: 5 JUN 2013
- Manuscript Revised: 30 MAY 2013
- Manuscript Received: 25 MAR 2013
- epsilon aminocaproic acid;
- antifibrinolytic agent;
- hematologic malignancies
Despite prophylactic platelet transfusions, bleeding remains a significant problem in thrombocytopenic patients.
The antifibrinolytic agent epsilon aminocaproic acid (EACA) was administered to 44 chronically (median duration, 273 days) and severely (platelet count, 8 × 109/L; range, 1 × 109/L- 19 × 109/L) thrombocytopenic patients with hematological malignancies. Prophylactic EACA at a dose of 1 g twice daily was orally administered for a median duration of 47 days (range, 7 days-209 days) until the platelet count recovered to > 30; × 109/L. Platelets were only transfused if bleeding occurred.
While receiving EACA, 59% of the patients did not bleed, 25% had 19 episodes of spontaneously resolving minor bleeding that did not require platelet transfusion, and 16% received a median of 4 platelet transfusions (range, 1 transfusion-8 transfusions) for 1 major traumatic and 9 spontaneous grade 2 to grade 3 bleeding (based on the World Health Organization classification of idiopathic thrombocytopenic purpura). No EACA toxicities were noted, and venous thromboses were not observed.
EACA is well tolerated and is associated with a low risk of major bleeding in patients with hematological malignancies who are experiencing chronic severe thrombocytopenia. Cancer 2013;119:3784–3787. © 2013 American Cancer Society.