Anticoagulation in thrombocytopenic patients: Time to rethink?

Jecko Thachil*, Marc Carrier, Ton Lisman

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

2 Citations (Scopus)
14 Downloads (Pure)


One of the difficult clinical situations in the anticoagulation era is how to give these medications to patients with significantly reduced platelet counts. The concern is the heightened bleeding risk, and the current practice is to apply a certain platelet count threshold below which the use of anticoagulant is deemed unsafe. However, this is not an evidence-based approach especially because the thresholds arose from studies in patients with acute leukemia. In this forum article, we discuss the bleeding risk estimation in thrombocytopenic patients when the decreased counts may not be related to marrow underproduction and aim to identify possible markers which can help in this risk estimation beyond platelet counts. We exhort future studies to include a combination of these markers, which may then guide us to administer safe anticoagulation in patients with severe thrombocytopenia.

Original languageEnglish
Number of pages1951
JournalJournal of Thrombosis and Haemostasis
Issue number9
Early online date18-Jun-2022
Publication statusPublished - Sept-2022


  • anticoagulation
  • bleeding
  • platelets
  • thrombocytopenia
  • thrombosis

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