TXA Infusions

• Indian Journal of Palliative Care 2021
• High-dose Continuous Infusion of Tranexamic Acid for Controlling Life-Threatening Bleed in Advanced Cancer Patients
• 2 cases of use of 240 mg/h IV infusions w good effect

TXA for Cancer?

• Repurposing TXA as an Anticancer Agent-Law et. al. 2021
• TXA may exhibit anticancer activity by blockade of extracellular plasmin formation
• May reduce cancer growth in vivo.

Thrombocytopenia does not reduce the risk of VTE
*PLT

Intracranial malignancies are at increased risk for bleeding and clotting at the same time

COVID & Cancer = CLOT (and bleed)

IVCF

• Only for patients with life-threatening VTE and absolute contraindications to anticoagulation
• Retrievable filter preferred
• ASCO guidelines

cancer VTE=min 6 months duration

Which DOAC w Cancer?

• May be Apixaban based on the ADAM VTE trial
• Supported in the Caravaggio Trial

Avoid DOACs in...

• Caution w GI/GU tumours
• Advanced renal disease (esp. CrCL
• Advanced cirrhosis (CP B or C)
• Caution w intracranial lesions, recent brain surgery

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