Management of antiplatelet drugs in thrombocytopenic cancer

The use of antiplatelet drugs in thrombocytopenic cancer patients requires balancing the increased risks of arterial thrombosis and bleeding. Using choice experiments, dr. Avi Leader (Maastricht University, the Netherlands) provided insight in physician’s real-world decisions.

145 hematologists or thrombosis/transfusion specialists, mainly from Italy, Israel, and the Netherlands, responded to 434 cases. Physician-assessed bleeding and thrombotic risk were found to consistently and logically influence all levels of management, with surprisingly little variance between physicians. The decision process is complex and affected by physician characteristics as well as a large number of patient variables.

Platelet transfusions were frequently chosen to support continuing anti-platelet drugs, although no evidence supports this practice. “The factors identified in our analysis should be considered when planning prospective management studies in this population.”

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