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Effect of beta-blockers, Ca2+ antagonists, and benzodiazepines on bleeding incidence in patients with chemotherapy induced thrombocytopenia

Rysler, Christine and Stoffel, Nadina and Buser, Andreas and Gratwohl, Alois and Tsakiris, Dimitrios A. and Stern, Martin. (2010) Effect of beta-blockers, Ca2+ antagonists, and benzodiazepines on bleeding incidence in patients with chemotherapy induced thrombocytopenia. Platelets, Vol. 21, H. 1. pp. 77-83.

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Official URL: http://edoc.unibas.ch/dok/A6006303

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Abstract

Beta-1-adrenoreceptor antagonists, Ca(2+) antagonists, and benzodiazepines negatively affect platelet aggregation in vitro. Few data exists on whether platelet function in vivo is relevantly influenced by exposure to any these substances. We analysed in three cohorts of 100 patients each treated with allogeneic hematopoietic stem cell transplantation (HSCT), autologous HSCT, and intensive chemotherapy, respectively, whether treatment with these drugs was associated with an increased risk of bleeding. Cumulative incidences of bleeding in the three cohorts were 47 +/- 5% after allogeneic transplants, 30 +/- 5% after autologous transplant, and 46 +/- 5% after chemotherapy (p = 0.008). Exposure to beta-blockers (hazard ratio [HR] 0.71, p = 0.32), Ca(2+) antagonists (HR 0.90, p = 0.73), and benzodiazepines (HR 1.18, p = 0.29) did not significantly increase the risk of bleeding in any cohort. Instead, bleeding risk was determined by platelet count, presence of inflammation, azotemia, presence of graft-versus-host disease and treatment with low-molecular weight heparin. After correcting for these factors, no differences in bleeding risk were seen between the three cohorts. In conclusion, therapy with Beta-1-adrenoreceptor antagonists, Ca(2+) antagonists, and benzodiazepines did not appear to significantly increase the risk for hemorrhagic complications in patients with iatrogenic severe thrombocytopenia.
Faculties and Departments:03 Faculty of Medicine > Bereich Querschnittsfächer (Klinik) > Ehemalige Einheiten Querschnittsfächer (Klinik) > Hämostaselabor (Marbet)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Querschnittsfächer (Klinik) > Ehemalige Einheiten Querschnittsfächer (Klinik) > Hämostaselabor (Marbet)
03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Ehemalige Einheiten Medizinische Fächer (Klinik) > Hämatologie (Gratwohl)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Ehemalige Einheiten Medizinische Fächer (Klinik) > Hämatologie (Gratwohl)
03 Faculty of Medicine > Departement Biomedizin > Former Units at DBM > Immunotherapy (Stern)
UniBasel Contributors:Gratwohl, Alois A. and Tsakiris, Dimitrios A. and Stern, Martin Andreas
Item Type:Article, refereed
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:Taylor & Francis
ISSN:0953-7104
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:21 Jun 2013 12:29
Deposited On:21 Jun 2013 12:25

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