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This prospective cohort study evaluated whether rotational thromboelastometry (<jats:styled-content style=\"fixed-case\">ROTEM<\/jats:styled-content>), coagulation or other platelet parameters were more strongly associated with bleeding than <jats:styled-content style=\"fixed-case\">TPC<\/jats:styled-content>. Adults treated at two <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content> haematology centres for haematological malignancy were enrolled if they had thrombocytopenia (<jats:styled-content style=\"fixed-case\">TPC<\/jats:styled-content>\u00a0\u2264\u00a050\u00a0\u00d7\u00a010<jats:sup>9<\/jats:sup>\/l) at beginning of, or during treatment (International Standard Randomized Controlled Trial Number 81226121). <jats:styled-content style=\"fixed-case\">TPC<\/jats:styled-content> and bleeding symptoms were recorded daily for up to 30\u00a0d or until platelet count recovery, hospital discharge or death. Blood samples were tested thrice weekly using <jats:styled-content style=\"fixed-case\">ROTEM<\/jats:styled-content>, Platelet Function Analyser (<jats:styled-content style=\"fixed-case\">PFA<\/jats:styled-content>)\u2010100<jats:sup>\u00ae<\/jats:sup>, coagulation and platelet cytometry assays. Bleeding symptoms and <jats:styled-content style=\"fixed-case\">TPC<\/jats:styled-content> from 49\/50 enrolled participants who completed the study were recorded on 754\/760 study days. Mean platelet volume and <jats:styled-content style=\"fixed-case\">PFA<\/jats:styled-content>\u2010100<jats:sup>\u00ae<\/jats:sup> closure times were frequently inestimatable because of thrombocytopenia. <jats:styled-content style=\"fixed-case\">TPC<\/jats:styled-content>, absolute immature platelet number (<jats:styled-content style=\"fixed-case\">AIPN<\/jats:styled-content>) and <jats:styled-content style=\"fixed-case\">ROTEM<\/jats:styled-content> maximum clot firmness were significantly associated with bleeding on the day after blood sampling. Only <jats:styled-content style=\"fixed-case\">AIPN<\/jats:styled-content> was associated with bleeding after adjustment of test results for <jats:styled-content style=\"fixed-case\">TPC<\/jats:styled-content> (Odds Ratio 0\u00b752, 95% confidence interval 0\u00b728\u20130\u00b797; <jats:italic>P\u00a0=<\/jats:italic>\u00a00\u00b7038). In a predictive model, <jats:styled-content style=\"fixed-case\">AIPN<\/jats:styled-content> was superior to <jats:styled-content style=\"fixed-case\">TPC<\/jats:styled-content> for predicting bleeding. This study indicates that <jats:styled-content style=\"fixed-case\">AIPN<\/jats:styled-content> may be more clinically useful than <jats:styled-content style=\"fixed-case\">TPC<\/jats:styled-content> at predicting bleeding.<\/jats:p>","DOI":"10.1111\/bjh.12928","type":"journal-article","created":{"date-parts":[[2014,5,5]],"date-time":"2014-05-05T06:12:42Z","timestamp":1399270362000},"page":"581-591","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["Prospective observational cohort study of the association between thromboelastometry, coagulation and platelet parameters and bleeding in patients with haematological malignancies\u2010 The <scp>ATHENA<\/scp> study"],"prefix":"10.1111","volume":"166","author":[{"given":"Lise J.","family":"Estcourt","sequence":"first","affiliation":[{"name":"NHS Blood and Transplant Oxford UK"},{"name":"Radcliffe Department of Medicine University of Oxford Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon J.","family":"Stanworth","sequence":"additional","affiliation":[{"name":"NHS Blood and Transplant Oxford UK"},{"name":"Radcliffe Department of Medicine University of Oxford Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Harrison","sequence":"additional","affiliation":[{"name":"School of Immunity and Infection College of Medical and Dental Sciences University of Birmingham Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gillian","family":"Powter","sequence":"additional","affiliation":[{"name":"NHS Blood and Transplant Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marianne","family":"McClure","sequence":"additional","affiliation":[{"name":"Haematology Department University of Oxford Hospitals NHS Trust Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael F.","family":"Murphy","sequence":"additional","affiliation":[{"name":"NHS Blood and Transplant Oxford UK"},{"name":"Radcliffe Department of Medicine University of Oxford Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew D.","family":"Mumford","sequence":"additional","affiliation":[{"name":"School of Cellular and Molecular Medicine University of Bristol Bristol UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,5,5]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2013.11.008"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2010-11-321398"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2012.03918.x"},{"key":"e_1_2_9_5_1","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1046\/j.1365-2141.2003.04468.x","article-title":"British Committee for Standards in Haematology: guidelines for the use of platelet transfusions","volume":"122","author":"BCSH","year":"2003","journal-title":"British Journal of Haematology"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12026-009-8106-9"},{"key":"e_1_2_9_7_1","unstructured":"Bolton\u2010Maggs P.H.B.(Ed) Poles D. 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