Biomarkers in patients with anemia-induced thrombocytopenic bleeding (BAIT): A pilot study

Patients with acute myeloid leukemia (AML) have a uniquely high risk of bleeding. After receiving chemotherapy, they often develop severely low platelets and hemoglobin levels. This phenomenon, called anemia-induced thrombocytopenic bleeding [1], has been well described in animal models, but the effect in humans has not been adequately addressed. In this pilot trial, we will randomly assign patients to receive red blood cell (RBC) transfusions to maintain a hemoglobin level that is closer to normal (110 g/L) or a standard level (70 – 80 g/L). We will measure markers in the blood and urine which will indicate a heightened bleeding risk focusing on three domains: inflammation, fibrinolysis/coagulation, and endothelial damage. Bleeding occurrences in patients will be evaluated daily, and they will be correlated with hemoglobin levels. The results of this study will set the stage for a large clinical trial to evaluate different hemoglobin levels on the risk of bleeding in patients with AML. Ultimately, this research will lead to a better understanding of the effects of low hemoglobin and low platelet levels on the risk of bleeding and will allow us to make better decisions about the use of RBC transfusions.

ARNOLD, Donald

McMaster University

Intramural Research Grant Program

Ontario

$200,000