{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T15:18:43Z","timestamp":1787239123449,"version":"build-2736575974"},"reference-count":21,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,10,7]],"date-time":"2024-10-07T00:00:00Z","timestamp":1728259200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["HL122272"],"award-info":[{"award-number":["HL122272"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["HL122894"],"award-info":[{"award-number":["HL122894"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["HL143403"],"award-info":[{"award-number":["HL143403"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["HL146226"],"award-info":[{"award-number":["HL146226"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Despite prophylactic platelet transfusions, hypoproliferative thrombocytopenia is associated with bleeding; historical risk factors include hematocrit (HCT) 25%, activated partial thromboplastin time 30\u2009s, international normalized ratio 1.2, and platelets5000\/\u03bcL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a post hoc analysis of bleeding outcomes and risk factors in participants with hematologic malignancy and hypoproliferative thrombocytopenia enrolled in the American Trial to Evaluate Tranexamic Acid Therapy in Thrombocytopenia (A\u2010TREAT) and randomized to receive either tranexamic acid (TXA) or placebo.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      World Health Organization (WHO) grade 2+ bleeding occurred in 46% of 330 participants, with no difference between the TXA (44%) and placebo (47%) groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.66). Overall, the most common sites of bleeding were oronasal (18%), skin (17%), gastrointestinal (11%), and genitourinary (11%). Among participants of childbearing potential, 28% experienced vaginal bleeding. Platelets \u22645000\/\u03bcL and HCT\u2009&lt;\u200921% (after adjusting for severe thrombocytopenia) were independently associated with increased bleeding risk (HR 3.78, 95% CI 2.16\u20136.61; HR 2.67, 95% CI 1.35\u20135.27, respectively). Allogeneic stem cell transplant was associated with nonsignificant increased risk of bleeding versus chemotherapy alone (HR 1.34, 95% CI 0.94\u20131.91).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>The overall rate of WHO grade 2+ bleeding was similar to previous reports, albeit with lower rates of gastrointestinal bleeding. Vaginal bleeding was common in participants of childbearing potential. Platelets \u22645000\/\u03bcL remained a risk factor for bleeding. Regardless of platelet count, bleeding risk increased with HCT\u2009&lt;\u200921%, suggesting a red blood cell transfusion threshold above 21% should be considered to mitigate bleeding. More investigation is needed on strategies to reduce bleeding in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/trf.18028","type":"journal-article","created":{"date-parts":[[2024,10,7]],"date-time":"2024-10-07T05:59:25Z","timestamp":1728280765000},"page":"2055-2062","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Analysis of bleeding outcomes in patients with hypoproliferative thrombocytopenia in the A\u2010\n                    <scp>TREAT<\/scp>\n                    clinical trial"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2431-5106","authenticated-orcid":false,"given":"Jacqueline N.","family":"Poston","sequence":"first","affiliation":[{"name":"Division of Hematology &amp; Oncology, Department of Medicine Larner College of Medicine at the University of Vermont  Burlington Vermont USA"},{"name":"Division of Clinical Pathology, Department of Pathology &amp; Laboratory Medicine Larner College of Medicine at the University of Vermont  Burlington Vermont USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siobhan P.","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy Sarah","family":"Ginsburg","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anton","family":"Ilich","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Hematology and Blood Research Center University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Herren","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nahed","family":"El Kassar","sequence":"additional","affiliation":[{"name":"Division of Blood Diseases and Resources, National Institutes of Health National Heart, Lung and Blood Institute  Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darrell J.","family":"Triulzi","sequence":"additional","affiliation":[{"name":"Department of Pathology, Division of Transfusion Medicine University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nigel S.","family":"Key","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Hematology and Blood Research Center University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"May","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terry B.","family":"Gernsheimer","sequence":"additional","affiliation":[{"name":"Division of Hematology &amp; Oncology University of Washington School of Medicine and Fred Hutchinson Cancer Center  Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,10,7]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2022016308"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0904084"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2017-01-757930"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2014.118075"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.12914"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2007.01465.x"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.1994.tb04737.x"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.1988.28588337325.x"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/0026-2862(75)90070-9"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.ATV.0000229658.76797.30"},{"key":"e_1_2_8_12_1","article-title":"RBCs regulate platelet function and hemostasis under shear conditions through biophysical and biochemical means","author":"Jiang D","year":"2024","journal-title":"Blood"},{"issue":"5","key":"e_1_2_8_13_1","article-title":"Restrictive versus liberal red blood cell transfusion strategies for people with haematological malignancies treated with intensive chemotherapy or radiotherapy, or both, with or without haematopoietic stem cell support","volume":"5","author":"Radford M","year":"2024","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2021.279867"},{"issue":"11","key":"e_1_2_8_15_1","first-page":"1530","article-title":"The risk of bleeding in thrombocytopenic patients with acute myeloid leukemia","volume":"91","author":"Webert K","year":"2006","journal-title":"Haematologica"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.13658"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2022-157619"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.19.01836"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1212772"},{"issue":"7","key":"e_1_2_8_20_1","article-title":"Pathogen\u2010reduced platelets for the prevention of bleeding","volume":"7","author":"Estcourt LJ","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.2000.40040398.x"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.17720"}],"container-title":["Transfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/trf.18028","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,18]],"date-time":"2024-11-18T21:57:56Z","timestamp":1731967076000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/trf.18028"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,7]]},"references-count":21,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2024,11]]}},"alternative-id":["10.1111\/trf.18028"],"URL":"https:\/\/doi.org\/10.1111\/trf.18028","archive":["Portico"],"relation":{},"ISSN":["0041-1132","1537-2995"],"issn-type":[{"value":"0041-1132","type":"print"},{"value":"1537-2995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,7]]},"assertion":[{"value":"2024-07-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}