Thromboelastography (TEG®) compared with total platelet count in thrombocytopenia haematological malignancy patients with bleeding: a pilot observational study

SUMMARY Background There has been no reported use of Thromboelastography® (TEG®) in assessing thrombocytopenic haematological malignancy (HM) patients experiencing bleeding. Objectives To assess whether there are differences in TEG® variables in thrombocytopenic HM patients experiencing clinically significant bleeding compared with those not experiencing bleeding. Methods Thirty adult patients with HM and a total platelet count (TPC) of ≤30 × 109 L−1 were observed for greater than or equal to grade two World Health Organisation (WHO) bleeding episodes for 72 h. They had TPC, TEG® parameters [maximal amplitude (MA), reaction time (R‐time), alpha (α‐angle) and functional fibrinogen (FF) levels], activated partial thromboplastin time (APTT) and prothrombin time (PT) measured at inclusion, 24 and 48 h. Results Five patients had nine significant bleeding episodes. Patients bleeding (n) were all more hypocoaguable when measured by TEG® than patients not bleeding at inclusion n = 4 (MA: 16·9 vs 31·8 mm, P