A trial of tranexamic acid for low platelet counts (TREATT)
Cancer type:
Status:
Phase:
This trial looked at using a drug called tranexamic acid to treat low 
counts caused by cancer.
The trial was open to people with a blood cancer () who had treatment with or a .
The trial was open for people to join between 2015 and 2022. The team published the results in 2024.
You pronounce tranexamic acid as tran-ex-zam-ic ass-id.
More about this trial
Bleeding can be a problem for people with a haematological malignancy. This could be because of the cancer itself or from treatment such as high dose chemotherapy or stem cell transplant.
Doctors can give these people a to treat bleeding. Tranexamic acid is a drug that can treat or prevent blood loss. It is used in surgery and other medical conditions where bleeding can be a problem. The trial team thought it may help people with haematological malignancies.
People taking part had blood tests done to check on the number of platelets in their blood. When their platelets dropped below a certain level, they had either tranexamic acid or a dummy drug (). They also had a platelet transfusion if necessary.
The aim of this trial was to find out whether tranexamic acid reduced bleeding for people with haematological malignancies.
Summary of results
This trial was for people who had intensive chemotherapy, or a stem cell transplant and their platelet count was below a certain level for at least 5 days.
It was an international . In this 616 people took part. A computer put them into 1 of 2 groups. Neither they nor their doctor knew which group they were in. The groups were:
- 310 had tranexamic acid
- 306 had the dummy drug
The team were able to look at the results of 597 people:
- 300 had tranexamic acid
- 297 had the dummy drug
The team looked at how many people in each group either died or had a moderate to severe bleed after having their high dose chemotherapy or stem cell transplant. They found it was:
- 90 people who had tranexamic acid
- 98 people who had the dummy drug
- the person has to go to hospital because of it
- it is particularly important for the specific treatment in the trial
No one had a serious side effect caused by the treatment.
Conclusion
The team concluded that there was not enough evidence to support the routine use of tranexamic acid for people who have had high intensity chemotherapy.
Although this trial did not show that tranexamic acid was useful it still added to our knowledge and understanding of cancer and how to treat it.
More detailed information
There is more information about this research in the reference below.
Please note, the information we link to here is not in plain English. It has been written for healthcare professionals and researchers.
Tranexamic acid versus placebo to prevent bleeding in patients with haematological malignancies and severe thrombocytopenia (TREATT): a randomised, double-blind, parallel, phase 3 superiority trial
L J Estcourt and others
The lancet Haematology, 2025. Volume 12, issue 1, pages E14 to E22.
Where this information comes from
We have based this summary on the information in the article above. This has been reviewed by independent specialists () and published in a medical journal. We have not analysed the data ourselves.
Recruitment start:
Recruitment end:
How to join a clinical trial
Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.
Chief Investigator
Dr Lise Estcourt
Dr Simon Stanworth
Supported by
NIHR Clinical Research Network: Cancer
NHS Blood and Transplant (NHSBT)
Australian National Health and Medical Research Council (NHMRC)
If you have questions about the trial please contact our cancer information nurses
Freephone 0808 800 4040
