Venous Thromboembolism (VTE)

Patients with acute leukaemia are at high-risk of VTE. Thrombocytopaenia does not protect against VTE but does make treatment more challenging. The co-existence of indwelling catheters, DIC, reduced pharmacological VTE prophylaxis due to thrombocytopaenia, and occasionally chemotherapy drugs themselves, add to the risk of VTE formation.

If possible, radiological proof should be attained prior to treatment, and this may necessitate out of hours scanning. Patients with leukaemia and VTE can be anticoagulated if their platelet count is > 50 x 10⁹/L. If platelets are  <50 x 10⁹/L then discussion should be had with haematology about whether platelet transfusion is indicated to facilitate anticoagulation¹⁴.