TRial to EvaluAte Tranexamic Acid Therapy in Thrombocytopenia

Exclusion Criteria

• •A patient will not be eligible for this trial if he/she fulfils one or more of the following criteria:
• •1. Patients with a past history or current diagnosis of arterial or venous thromboembolic disease including myocardial infarction, peripheral vascular disease and retinal arterial or venous thrombosis.
• •2. Diagnosis of acute promyelocytic leukaemia (APML) and undergoing induction chemotherapy
• •3. Patients with a diagnosis/previous history of veno-occlusive disease (also called sinusoidal obstruction syndrome)
• •4. Patients with known inherited or acquired prothrombotic disorders e.g.
• •1. Lupus anticoagulant
• •2. Positive antiphospholipids
• •5. Patients receiving any pro-coagulant agents (e.g. DDAVP, recombinant Factor VIIa or Prothrombin Complex Concentrates (PCC) within 48 hours of enrolment, or with known hypercoagulable state
• •6. Patients receiving L-asparaginase as part of their current cycle of treatment
• •7. History of immune thrombocytopenia (ITP), thrombotic thrombocytopenic purpura (TTP) or haemolytic uraemic syndrome (HUS)
• •8. Patients with overt disseminated intravascular coagulation (DIC) (See Appendix 3 in the protocol for definition)
• •9. Patients requiring a platelet transfusion threshold \>10x10/⁹L at time of randomisation. (This refers to patients who require their platelet count to be maintained at a certain specified level on an ongoing basis, and excludes a transient rise in the threshold due to sepsis.)
• •10. Patients with a known inherited or acquired bleeding disorder e.g.
• •1. Acquired storage pool deficiency
• •2. Paraproteinaemia with platelet inhibition
• •11. Patients receiving anticoagulant therapy or anti-platelet therapy
• •12. Patients with visible haematuria at time of randomisation
• •13. Patients with anuria (defined as urine output \< 10 mls/hr over 24 hours).
• •14. Patients with severe renal impairment (eGFR ≤30 ml/min/1.73m²)
• •15. Patients with a previous history of epilepsy, convulsions, fits or seizures
• •16. Patients who are pregnant or breast-feeding
• •17. Allergic to tranexamic acid.
• •18. Patients enrolled in other trials involving platelet transfusions, anti-fibrinolytics, platelet growth factors or other pro-coagulant agents.
• •19. Patients previously randomised into this trial at any stage of their treatment.