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Prophylactic tranexamic acid in patients with hematologic malignancy: a placebo-controlled, randomized clinical trial

The antifibrinolytic agent tranexamic acid (TXA) is often used to prevent bleeding in patients with hemorrhagic disorders or platelet dysfunction, and there has been speculation that it might prevent bleeding in patients with thrombocytopenia. Gernsheimer and colleagues report on a randomized double-blind study of TXA vs placebo for patients with hematologic malignancy and treatment-related thrombocytopenia. The authors confirm that TXA does not significantly reduce the risk of WHO grade 2 or higher bleeding, nor does it decrease the need for platelet transfusions.