Safety of low-dose low-molecular-weight-heparins in thrombocytopenic stem cell transplantation patients : a case series and review of the literature
Few attempts have been made to examine the feasibility of safely administering low-molecular-weight-heparins (LMWHs) in the presence of concurrent thrombocytopenia. We retrospectively investigated the safety of low-dose LMWH in BMT patients, a population at risk of bleeding. In total, 26 patients re...
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| Veröffentlicht in: | Bone marrow transplantation (Basingstoke) 2005-06, Vol.35 (11), p.1071-1077 |
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| creator | IBRAHIM, R. B PERES, E DANSEY, R ABIDI, M. H ABELLA, E. M GUMMA, M. M MILAN, N SMITH, D. W HEILBRUN, L. K KLEIN, J |
| description | Few attempts have been made to examine the feasibility of safely administering low-molecular-weight-heparins (LMWHs) in the presence of concurrent thrombocytopenia. We retrospectively investigated the safety of low-dose LMWH in BMT patients, a population at risk of bleeding. In total, 26 patients received at least one dose of low-dose enoxaparin (ie |
| doi_str_mv | 10.1038/sj.bmt.1704952 |
| format | Article |
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B ; PERES, E ; DANSEY, R ; ABIDI, M. H ; ABELLA, E. M ; GUMMA, M. M ; MILAN, N ; SMITH, D. W ; HEILBRUN, L. K ; KLEIN, J</creator><creatorcontrib>IBRAHIM, R. B ; PERES, E ; DANSEY, R ; ABIDI, M. H ; ABELLA, E. M ; GUMMA, M. M ; MILAN, N ; SMITH, D. W ; HEILBRUN, L. K ; KLEIN, J</creatorcontrib><description>Few attempts have been made to examine the feasibility of safely administering low-molecular-weight-heparins (LMWHs) in the presence of concurrent thrombocytopenia. We retrospectively investigated the safety of low-dose LMWH in BMT patients, a population at risk of bleeding. In total, 26 patients received at least one dose of low-dose enoxaparin (ie <1 mg/kg/day) during thrombocytopenia. s.c. enoxaparin 40 mg once daily was given in 85% of the cohort. The mean number of platelet days <55 x 10(9) and <20 x 10(9)/l were 16.5 days (95% CI=8.04-24.96) and 4.14 days (95% CI=2.35-5.93), respectively. The mean number of low-dose enoxaparin administration days when platelet <55 x 10(9) and 20 x 10(9)/l were 9.89 days (95% CI=3.26-16.53) and 2.25 days (95% CI=0.57-3.93), respectively. Minor bleeding occurred in four patients (15%) whereas major episodes developed in two patients (8%). The latter two events occurred during the transition between full therapeutic (ie 1.5-2 mg/kg/day) and low-dose enoxaparin close to the onset of thrombocytopenia. The present case series, along with the discussed literature, descriptively suggests that low-dose enoxaparin may be safely administered at a platelet count in the range of 20 and 55 x 10(9)/l in BMT patients who weigh >55 kg.</description><identifier>ISSN: 0268-3369</identifier><identifier>EISSN: 1476-5365</identifier><identifier>DOI: 10.1038/sj.bmt.1704952</identifier><identifier>PMID: 15821771</identifier><identifier>CODEN: BMTRE9</identifier><language>eng</language><publisher>Basingstoke: Nature Publishing Group</publisher><subject>Adult ; Aged ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Anticoagulants - therapeutic use ; Biological and medical sciences ; Bleeding ; Blood Platelets - cytology ; Bone marrow ; Bone Marrow Transplantation - methods ; Bone marrow, stem cells transplantation. Graft versus host reaction ; Care and treatment ; Case studies ; Cohort Studies ; Complications and side effects ; Dosage and administration ; Enoxaparin - pharmacology ; Female ; Hematologic and hematopoietic diseases ; Hematopoietic stem cells ; Hemorrhage - prevention & control ; Heparin ; Heparin, Low-Molecular-Weight - therapeutic use ; Humans ; Literature reviews ; Male ; Medical sciences ; Methods ; Middle Aged ; Neoplasms - therapy ; Physiological aspects ; Platelet Count ; Platelet diseases and coagulopathies ; Platelets ; Prognosis ; Retrospective Studies ; Safety ; Stem cell transplantation ; Stem Cell Transplantation - methods ; Stem cells ; Thrombocytopenia ; Thrombocytopenia - therapy ; Time Factors ; Transfusions. Complications. Transfusion reactions. Cell and gene therapy ; Transplantation ; Weight</subject><ispartof>Bone marrow transplantation (Basingstoke), 2005-06, Vol.35 (11), p.1071-1077</ispartof><rights>2005 INIST-CNRS</rights><rights>COPYRIGHT 2005 Nature Publishing Group</rights><rights>Copyright Nature Publishing Group Jun 2005</rights><rights>Nature Publishing Group 2005.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c476t-94b1634ab57cd450668ef4f6c5aa118fa836c27b923c5949aab3ceafc220b2243</citedby><cites>FETCH-LOGICAL-c476t-94b1634ab57cd450668ef4f6c5aa118fa836c27b923c5949aab3ceafc220b2243</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16801234$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15821771$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>IBRAHIM, R. B</creatorcontrib><creatorcontrib>PERES, E</creatorcontrib><creatorcontrib>DANSEY, R</creatorcontrib><creatorcontrib>ABIDI, M. H</creatorcontrib><creatorcontrib>ABELLA, E. M</creatorcontrib><creatorcontrib>GUMMA, M. M</creatorcontrib><creatorcontrib>MILAN, N</creatorcontrib><creatorcontrib>SMITH, D. W</creatorcontrib><creatorcontrib>HEILBRUN, L. K</creatorcontrib><creatorcontrib>KLEIN, J</creatorcontrib><title>Safety of low-dose low-molecular-weight-heparins in thrombocytopenic stem cell transplantation patients : a case series and review of the literature</title><title>Bone marrow transplantation (Basingstoke)</title><addtitle>Bone Marrow Transplant</addtitle><description>Few attempts have been made to examine the feasibility of safely administering low-molecular-weight-heparins (LMWHs) in the presence of concurrent thrombocytopenia. We retrospectively investigated the safety of low-dose LMWH in BMT patients, a population at risk of bleeding. In total, 26 patients received at least one dose of low-dose enoxaparin (ie <1 mg/kg/day) during thrombocytopenia. s.c. enoxaparin 40 mg once daily was given in 85% of the cohort. The mean number of platelet days <55 x 10(9) and <20 x 10(9)/l were 16.5 days (95% CI=8.04-24.96) and 4.14 days (95% CI=2.35-5.93), respectively. The mean number of low-dose enoxaparin administration days when platelet <55 x 10(9) and 20 x 10(9)/l were 9.89 days (95% CI=3.26-16.53) and 2.25 days (95% CI=0.57-3.93), respectively. Minor bleeding occurred in four patients (15%) whereas major episodes developed in two patients (8%). The latter two events occurred during the transition between full therapeutic (ie 1.5-2 mg/kg/day) and low-dose enoxaparin close to the onset of thrombocytopenia. The present case series, along with the discussed literature, descriptively suggests that low-dose enoxaparin may be safely administered at a platelet count in the range of 20 and 55 x 10(9)/l in BMT patients who weigh >55 kg.</description><subject>Adult</subject><subject>Aged</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Anticoagulants - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Bleeding</subject><subject>Blood Platelets - cytology</subject><subject>Bone marrow</subject><subject>Bone Marrow Transplantation - methods</subject><subject>Bone marrow, stem cells transplantation. Graft versus host reaction</subject><subject>Care and treatment</subject><subject>Case studies</subject><subject>Cohort Studies</subject><subject>Complications and side effects</subject><subject>Dosage and administration</subject><subject>Enoxaparin - pharmacology</subject><subject>Female</subject><subject>Hematologic and hematopoietic diseases</subject><subject>Hematopoietic stem cells</subject><subject>Hemorrhage - prevention & control</subject><subject>Heparin</subject><subject>Heparin, Low-Molecular-Weight - therapeutic use</subject><subject>Humans</subject><subject>Literature reviews</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Methods</subject><subject>Middle Aged</subject><subject>Neoplasms - therapy</subject><subject>Physiological aspects</subject><subject>Platelet Count</subject><subject>Platelet diseases and coagulopathies</subject><subject>Platelets</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Safety</subject><subject>Stem cell transplantation</subject><subject>Stem Cell Transplantation - methods</subject><subject>Stem cells</subject><subject>Thrombocytopenia</subject><subject>Thrombocytopenia - therapy</subject><subject>Time Factors</subject><subject>Transfusions. 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B ; PERES, E ; DANSEY, R ; ABIDI, M. H ; ABELLA, E. M ; GUMMA, M. M ; MILAN, N ; SMITH, D. W ; HEILBRUN, L. K ; KLEIN, J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c476t-94b1634ab57cd450668ef4f6c5aa118fa836c27b923c5949aab3ceafc220b2243</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Anticoagulants - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Bleeding</topic><topic>Blood Platelets - cytology</topic><topic>Bone marrow</topic><topic>Bone Marrow Transplantation - methods</topic><topic>Bone marrow, stem cells transplantation. Graft versus host reaction</topic><topic>Care and treatment</topic><topic>Case studies</topic><topic>Cohort Studies</topic><topic>Complications and side effects</topic><topic>Dosage and administration</topic><topic>Enoxaparin - pharmacology</topic><topic>Female</topic><topic>Hematologic and hematopoietic diseases</topic><topic>Hematopoietic stem cells</topic><topic>Hemorrhage - prevention & control</topic><topic>Heparin</topic><topic>Heparin, Low-Molecular-Weight - therapeutic use</topic><topic>Humans</topic><topic>Literature reviews</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Methods</topic><topic>Middle Aged</topic><topic>Neoplasms - therapy</topic><topic>Physiological aspects</topic><topic>Platelet Count</topic><topic>Platelet diseases and coagulopathies</topic><topic>Platelets</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Safety</topic><topic>Stem cell transplantation</topic><topic>Stem Cell Transplantation - methods</topic><topic>Stem cells</topic><topic>Thrombocytopenia</topic><topic>Thrombocytopenia - therapy</topic><topic>Time Factors</topic><topic>Transfusions. Complications. Transfusion reactions. Cell and gene therapy</topic><topic>Transplantation</topic><topic>Weight</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>IBRAHIM, R. B</creatorcontrib><creatorcontrib>PERES, E</creatorcontrib><creatorcontrib>DANSEY, R</creatorcontrib><creatorcontrib>ABIDI, M. H</creatorcontrib><creatorcontrib>ABELLA, E. M</creatorcontrib><creatorcontrib>GUMMA, M. M</creatorcontrib><creatorcontrib>MILAN, N</creatorcontrib><creatorcontrib>SMITH, D. W</creatorcontrib><creatorcontrib>HEILBRUN, L. 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B</au><au>PERES, E</au><au>DANSEY, R</au><au>ABIDI, M. H</au><au>ABELLA, E. M</au><au>GUMMA, M. M</au><au>MILAN, N</au><au>SMITH, D. W</au><au>HEILBRUN, L. K</au><au>KLEIN, J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Safety of low-dose low-molecular-weight-heparins in thrombocytopenic stem cell transplantation patients : a case series and review of the literature</atitle><jtitle>Bone marrow transplantation (Basingstoke)</jtitle><addtitle>Bone Marrow Transplant</addtitle><date>2005-06-01</date><risdate>2005</risdate><volume>35</volume><issue>11</issue><spage>1071</spage><epage>1077</epage><pages>1071-1077</pages><issn>0268-3369</issn><eissn>1476-5365</eissn><coden>BMTRE9</coden><abstract>Few attempts have been made to examine the feasibility of safely administering low-molecular-weight-heparins (LMWHs) in the presence of concurrent thrombocytopenia. We retrospectively investigated the safety of low-dose LMWH in BMT patients, a population at risk of bleeding. In total, 26 patients received at least one dose of low-dose enoxaparin (ie <1 mg/kg/day) during thrombocytopenia. s.c. enoxaparin 40 mg once daily was given in 85% of the cohort. The mean number of platelet days <55 x 10(9) and <20 x 10(9)/l were 16.5 days (95% CI=8.04-24.96) and 4.14 days (95% CI=2.35-5.93), respectively. The mean number of low-dose enoxaparin administration days when platelet <55 x 10(9) and 20 x 10(9)/l were 9.89 days (95% CI=3.26-16.53) and 2.25 days (95% CI=0.57-3.93), respectively. Minor bleeding occurred in four patients (15%) whereas major episodes developed in two patients (8%). The latter two events occurred during the transition between full therapeutic (ie 1.5-2 mg/kg/day) and low-dose enoxaparin close to the onset of thrombocytopenia. The present case series, along with the discussed literature, descriptively suggests that low-dose enoxaparin may be safely administered at a platelet count in the range of 20 and 55 x 10(9)/l in BMT patients who weigh >55 kg.</abstract><cop>Basingstoke</cop><pub>Nature Publishing Group</pub><pmid>15821771</pmid><doi>10.1038/sj.bmt.1704952</doi><tpages>7</tpages></addata></record> |
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| identifier | ISSN: 0268-3369 |
| ispartof | Bone marrow transplantation (Basingstoke), 2005-06, Vol.35 (11), p.1071-1077 |
| issn | 0268-3369 1476-5365 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals; Nature Journals Online; EZB-FREE-00999 freely available EZB journals |
| subjects | Adult Aged Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Anticoagulants - therapeutic use Biological and medical sciences Bleeding Blood Platelets - cytology Bone marrow Bone Marrow Transplantation - methods Bone marrow, stem cells transplantation. Graft versus host reaction Care and treatment Case studies Cohort Studies Complications and side effects Dosage and administration Enoxaparin - pharmacology Female Hematologic and hematopoietic diseases Hematopoietic stem cells Hemorrhage - prevention & control Heparin Heparin, Low-Molecular-Weight - therapeutic use Humans Literature reviews Male Medical sciences Methods Middle Aged Neoplasms - therapy Physiological aspects Platelet Count Platelet diseases and coagulopathies Platelets Prognosis Retrospective Studies Safety Stem cell transplantation Stem Cell Transplantation - methods Stem cells Thrombocytopenia Thrombocytopenia - therapy Time Factors Transfusions. Complications. Transfusion reactions. Cell and gene therapy Transplantation Weight |
| title | Safety of low-dose low-molecular-weight-heparins in thrombocytopenic stem cell transplantation patients : a case series and review of the literature |
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