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Platelet count is not the only determinant of bleeding and additional mechanisms for impending haemostasis are likely. Beside clot formation, platelets are essential for the maintenance of integrity of vascular beds. We therefore prospectively investigated associations between biomarkers for endothelial damage (urine albumin excretion) and inflammation (C\u2010reactive protein) and bleeding (WHO grading) in 88 patients with 116 on\u2010protocol episodes. We found an increase in grade 2 bleeding with a higher urine albumin\/creatinine ratio one day after the measurement [odds ratio (OR) 1\u00b724 for every doubling of the ratio, 95% CI 1\u00b705\u20131\u00b746, <jats:italic>P<\/jats:italic>\u2010value 0\u00b701] and a 29% increase in the odds of grade 2 bleeding for every doubling of serum C\u2010reactive protein (CRP) (95% CI 1\u00b704\u20131\u00b760, <jats:italic>P<\/jats:italic>\u2010value 0\u00b702) after correction for morning platelet count. The 24\u00a0h post\u2010transfusion corrected count increment (CCI<jats:sub>24<\/jats:sub>) showed a significant association with these biomarkers: increasing urine albumin\/creatinine ratio and CRP were associated with lower CCI<jats:sub>24.<\/jats:sub> We report two inexpensive and easy\u2010to\u2010apply biomarkers that could be useful in designing a prediction model for bleeding risk in thrombocytopenic patients.<\/jats:p>","DOI":"10.1111\/bjh.16291","type":"journal-article","created":{"date-parts":[[2019,11,15]],"date-time":"2019-11-15T17:43:13Z","timestamp":1573839793000},"page":"171-181","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["The association between haemorrhage and markers of endothelial insufficiency and inflammation in patients with hypoproliferative thrombocytopenia: a cohort study"],"prefix":"10.1111","volume":"189","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1250-7979","authenticated-orcid":false,"given":"Paula F.","family":"Ypma","sequence":"first","affiliation":[{"name":"Center for Clinical Transfusion Research Sanquin Leiden the Netherlands"},{"name":"Department of Hematology Haga Ziekenhuis Den Haag the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan","family":"van Geloven","sequence":"additional","affiliation":[{"name":"Department of Biomedical Data Sciences Section Medical Statistics Leiden University Medical Center Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean Louis H.","family":"Kerkhoffs","sequence":"additional","affiliation":[{"name":"Center for Clinical Transfusion Research Sanquin Leiden the Netherlands"},{"name":"Department of Hematology Haga Ziekenhuis Den Haag the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"te Boekhorst","sequence":"additional","affiliation":[{"name":"Department of Hematology Erasmus Medical Center Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaap J.","family":"Zwaginga","sequence":"additional","affiliation":[{"name":"Department of Immunohematology and Blood Transfusion Leiden University Medical Center Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik A. 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