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Evolution of Thromboelastography During Tranexamic Acid Treatment

Phase 2
Completed
Conditions
Hematological Malignancies Treated With Intensive Chemotherapy
Interventions
Registration Number
NCT03801122
Lead Sponsor
Centre Hospitalier Universitaire de Saint Etienne
Brief Summary

Patients with hematological malignancies are at increased risk of bleeding, especially during intensive chemotherapy. The aim of this study is to compare by thromboelastography changes during the intensive chemotherapy in patients with hematological malignancies.

Detailed Description

Patients with hematological malignancies often develop low platelet counts either as a consequence of the disease or the treatment by chemotherapy or stem cell transplantation. Platelet transfusions are commonly given to raise any low platelet count and reduce the risk of clinical bleeding (prophylaxis) or stop active bleeding (therapy). The last studies have showed that many patients continue to experience bleeding, despite the use of platelet transfusions. Tranexamic acid is an antifibrinolytic agent. It reduces the breakdown of clots formed. This treatment is widely used in medicine (e.g. emergency, surgery, post-partum) and decreases blood loss and the use of red cell transfusions. The purpose of this study is to test different doses of tranexamic acid (full dose: 3g/day and half dose (1.5g/day) and to study its effect by thromboelastography, with the aim to determine the optimal posology for further clinical studies.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
18
Inclusion Criteria
  • Patient affiliated to a social security regimen or beneficiary of the same
  • Signed written informed consent form
  • Confirmed diagnosis of a hematological malignancy and undergoing intensive chemotherapy
  • Expected to experience hypoproliferative thrombocytopenia resulting in a platelet count of ≤10 G/L for ≥ 5 days
Exclusion Criteria
  • Pregnant women
  • Patient under guardianship or deprived of his liberty or any condition that may affect the patient's ability to understand and sign the informed consent
  • Refractoriness to platelet transfusion or requirement for a specific type of platelet transfusion (ABO-compatible, plasma-free)
  • Ongoing anticoagulant therapy or antiplatelet therapy at the time of enrolment
  • Treatment with any pro-coagulant agent within 48 hours of enrolment, or enrolment in other trials involving platelet transfusions, platelet growth factors, or presentation of a known hypercoagulable state
  • Diagnosis of arterial or venous thromboembolic disease within the previous year
  • Patient experiencing a bleeding event WHO grade ≥ 2 within 7 days before inclusion
  • contra-indications to tranexamic acid (allergy, history of seizures, creatinine clearance < 30 mL/min)
  • Refusing participation

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Tranexamic acid 3g/dayTranexamic acidAdministration of tranexamic acid 3g/day, with 3 injections/8 hours.
Tranexamic acid 1.5g/dayTranexamic acidAdministration of tranexamic acid 1.5g/day, with 3 injections/8 hours.
Primary Outcome Measures
NameTimeMethod
Level of amplitude observed in thromboelastography30 days

Amplitude levels observed in thromboelastography will be reported

Secondary Outcome Measures
NameTimeMethod
Time at the beginning of the clot30 minutes

Time at the beginning of the clot will be reported in minutes

Clot formation time30 minutes

Clot formation time will ne reported in minutes

Alpha angle30 days

Alpha angle will be measured in degrees

Percentage of lysis after 30min30 minutes

Percentage of lysis after 30min will be measured

Number of adverse events3 months

Number of adverse events will be reported

Proportion of patients experiencing bleeding of WHO (World Health Organisation ) grade 2 or above30 days

Proportion of patients experiencing bleeding of WHO (World Health Organisation ) grade 2 or above will be reported

Trial Locations

Locations (1)

CHU de Saint-Etienne

🇫🇷

Saint-Étienne, France

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