Clinical trial · Interventional
STrategies for Anticoagulation in Patients With thRombocytopenia and Cancer-associated Thrombosis
- Source
- ClinicalTrials.gov
- Retrieved
- Sep 8, 2026
- Layer
- normalized (units and labels harmonized; values unchanged)
- Run
- ING-CLINICALTRIALS-20260908-000001
Summary
Brief summary (as posted)
Patients with cancer are prone to have blood clots, which are usually treated with blood thinners. The main complication of blood thinners is bleeding. This is especially a concern when the number of platelets in the blood is lower than 50,000 per microliter. The role of platelets is to stop bleeding, so when the number of platelets is low, patients are at a higher risk of bleeding. Cancer patients are prone to have lower platelet numbers due to cancer therapies and/or cancer itself. It is not clear what the best treatment is for cancer patients who need blood thinners for a blood clot but have low platelet counts. The investigators plan to do a small study called a pilot study to help plan for a larger study in such patients. In the pilot study, investigators will include 50 patients with cancer, low platelet counts, and a blood clot diagnosed within 2 weeks. Patients will be randomly assigned to one of the two treatment strategies: the full dose of blood thinners along with platelet transfusion or a reduced dose of blood thinners without platelet transfusion. The investigators will follow all patients for 30 days. If this pilot study is successful, it will help lead to a much larger trial, which will provide important information on the best treatment strategy for these patients.
Conditions
Conditions (2)
Free-text conditions as registered, with the CancerIndex entity they were reconciled to and the match type.
| Condition (as posted) | Mapped entity | Match | Confidence |
|---|---|---|---|
| Cancer-associated Thrombosis | — | UNRESOLVED | — |
| Thrombocytopenia | — | UNRESOLVED | — |
Interventions
Interventions (3)
| Intervention | Type | Mapped drug | Match |
|---|---|---|---|
| Dalteparin | Biological | — | UNRESOLVED |
| Enoxaparin | Biological | — | UNRESOLVED |
| Tinzaparin | Biological | — | UNRESOLVED |
Design
Arms and outcomes
Arms (2)
- type
- EXPERIMENTAL
- label
- Modified dose LMWH without platelet transfusion support
- description
- Patients will be given modified dose LMWH as below based on the first platelet count of the day (daily in admitted patients or at least 2 times a week in outpatients), without empiric platelet transfusion: I. Platelet count 25-50,000/µL: 50% dose LMWH II. Platelet count \< 25,000/µL: hold anticoagulation
- interventionNames
- Biological: Enoxaparin
- Biological: Dalteparin
- Biological: Tinzaparin
- type
- ACTIVE_COMPARATOR
- label
- Higher dose LMWH with platelet transfusion support
- description
- Patients assigned to higher dose LMWH (see below) will be given transfusion for 14 days when the first platelet count of the day falls below 50,000/uL (daily inpatient or at least 2 times a week in outpatients). Post-transfusion counts will not be routinely obtained unless clinically indicated I. Platelet count 25-50,000/µL: platelet transfusion + 100% dose LMWH II. Platelet count \< 25,000/µL: platelet transfusion + 50% dose LMWH After Day 14, patients will be transitioned to modified dose LMWH as the other arm without platelet transfusion. LMWH can include enoxaparin, dalteparin, or tinzaparin, with 100% as: * Enoxaparin - 1mg/kg subcutaneously twice daily * Dalteparin - 200 IU/kg subcutaneously daily for 1 month then 150 U/kg daily * Tinzaparin - 175 units/kg subcutaneously daily
Eligibility
Eligibility (as posted)
- Sex
- All
- Minimum age
- 18 Years
Show eligibility criteria text
Inclusion Criteria: 1. Adult patients (age ≥ 18) with active malignancy (malignancy diagnosed or treated within the previous 6 months, or progressive/relapsed); 2. Objectively confirmed VTE within last 14 days for which therapeutic anticoagulation is planned; 3. Thrombocytopenia with a platelet count \< 50,000/uL from cancer therapy or malignancy itself; 4. Able to provide written informed consent Exclusion Criteria: 1. Receipt of anticoagulant for index VTE with platelet count \< 50,000/uL for \> 72 hours; 2. Superficial vein thrombosis only; 3. Life expectancy \< 1 month (as judged by the treating physicians); 4. Creatinine clearance \< 30 ml/min; 5. Contraindication to LMWH such as a history of heparin induced thrombocytopenia; 6. Thrombocytopenia from other causes, such as thrombotic microangiopathy, immune thrombocytopenia, disseminated intravascular coagulation; 7. Previously documented history of refractoriness to platelet transfusion secondary to HLA antibodies; 8. Refusal of blood products; 9. Anticoagulation at any dose is deemed unsafe (i.e. active bleeding or bleeding disorders)
References
Publications (0)
Data not yet available