Sir,
The recent comment by Wiwanitkit[1] to our paper on anticoagulant (AC) and antiplatelet (AP) agents in the management of hematological malignancies in a home-care program[2] was valuable and interesting.
The author concluded, “This is no doubt the reason why the use of AC/AP in home healthcare seems to be uncommon in this report”[1] and “There appears to be a high incidence of complications or adverse events of AC/AP drugs in clinical practice and, therefore, the use of these drugs in home healthcare for cases with hematological malignancies might be considered a risk”.[1] Our opinion, however, is that firstly the frequency of use of the AC/AP in our case series is difficult to evaluate, being not properly comparable with similar realities, given the heterogeneity of both patients and AC/AP treatment indications; secondly, even the frequency of hemorrhagic complications there seems at least not higher than that observed in similar populations of patients.[3] Therefore, we believe that it is at least hasty to conclude that the use of AC/AP therapy in our series has been more limited than expected due to an excessive rate of bleeding complications.
Finally, we are extremely favorable to the dissemination and patient use of point-of-care testing (POCT) analyzer systems, while not believing that this should necessarily favor the spread of the use of AC/AP in home managed hematological patients.
REFERENCES
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