Jensa Morris: DOAC Safety in Low-Platelet CAT
Jensa Morris, Director of Smilow Hospitalist Service at Yale New Haven Hospital, shared a post on LinkedIn about a recent article by Mario Biglietto et al, published in RPTH, adding:
“Anticoagulating Cancer Associated Thrombosis (CAT) patients with low platelets may be safer than we think.
A retrospective single-center experience out of Sapienza University of Rome adds practical, real-world data to the difficult-but-common clinical problem of anticoagulating cancer patients with thrombocytopenia. Even in the context of a letter, the data are worth noting.
The numbers: 228 heme/onc patients on DOACs for VTE or atrial fibrillation, with DOAC therapy initiated when platelets were above 50 × 10⁹/L and discontinued below that threshold. Among the 24 patients (10.5%) who developed thrombocytopenia during treatment:
- 79.2% had no bleeding event at all
- Only 5 non-major bleeding events occurred in 30 patient-years
- Zero VTE recurrences
- Most bleeds were managed with a temporary switch to prophylactic enoxaparin, then resumed DOAC after around 10 days
Yes, this is a small, single-center, and hypothesis-generating work, but these are the real-world data that Onc Hospitalists need when standard trials exclude these patients. A useful addition to the conversation on anticoagulating CAT in the setting of cytopenias.”
Title: Anticoagulant management of cancer-associated thrombosis and thrombocytopenia: a retrospective chart review
Authors: Mario Biglietto, Silvia Sorella, Erica Crisanti, Marco Antonacci, Antonio Chistolini
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