Using prophylactic-dose LMWH carefully may be safe in people with thrombocytopenia with hematologic malignancy-associated venous thromboembolism (VTE), according to a study involving 128 individuals.

All participants had hematologic malignancies. Investigators compared those with and without significant thrombocytopenia. Among the results:

• More than one-third had a platelet count ≤50,000/µL during a time of apparent need for new or continued anticoagulation.
• Median nadir platelet count in those with significant thrombocytopenia was 10,000/µL vs 165,000/µL in those without.
• Significant thrombocytopenia lasted a median of 10 days.
• Prophylactic LMWH was used during significant thrombocytopenia in nearly half of patients.
• Therapeutic-dose LMWH or heparin was used in 3 in every 10 patients, warfarin in 2%, inferior vena cava filter in 2%, and observation in 17%.
• Risk of significant bleeding, major bleeding, and clot progression or recurrence was similar in both groups.
• Risk of recurrence/progression and hemorrhage rate was similar in both groups.