Management Of Venous Thromboembolism (Vte) In Thrombocytopenic Patients Undergoing Induction Chemotherapy For Acute Leukemia

Introduction: Management of VTE in patients with hematological malignancies is challenging as these patients often have thrombocytopenia and are at increased risk for bleeding. The International Society of Thrombosis and Hemostasis (ISTH) guidance statement recommends adjusting anticoagulation based on the severity and acuity of VTE and considering platelet transfusion support to maintain platelet counts above >50K/µL to facilitate full-dose anticoagulation (AC) in patients with acute VTE with high-risk features. For acute VTE with low-risk features, a dose-modified strategy such as half- or prophylactic-dose AC, depending on platelet count, is recommended. While the risk of AC with supportive platelet transfusions may be justified in patients with severe VTE, lower-dose AC without platelet transfusion support may be adequate for patients with non-severe VTE and may reduce the risk for development of platelet alloantibodies. To better understand practice patterns at our institution, we reviewed the management of VTE in patients with acute leukemia over an 8-year period.