부산대학교 도서관

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 31.8mm, P <0.01; R-time: 10.1 vs 7.5min, P =0.02; α-angle: 18.8 vs 28.4, P <0.01; FF: 182.4 vs 204mg dL-1, P <0.01), at 24 h n=3 (MA 18 vs 29.4mm, P =0.02; R-time: 9.4 vs 7.4mins, P =0.02; α-angle: 21.6 vs 26.5, P =0.04 and FF: 168 vs 201mg dL-1, P =0.01) and at 48 h n=2 (MA: 29.7 vs 23.0, P =0.02; R-time: 8.1 vs 6.7mins, P =0.05; α-angle: 22.6 vs 26.5, P =0.04; FF: 170 vs 208mg dL-1, P =0.01). There were no significant differences in TPC, APTT or PT between patients that bled and those that did not at each time point. Conclusions: Thrombocytopenic HM patients experiencing bleeding are hypocoaguable on TEG®. [ABSTRACT FROM AUTHOR]