Endoscopic intervention in hematologic malignancy patients with severe thrombocytopenia: Methodological concerns, clinical implications, and future research directions.

Gastrointestinal bleeding (GIB) presents a significant challenge for patients with hematologic malignancies, especially those with severe thrombocytopenia. Although endoscopic intervention is frequently used in managing GIB, its safety and effectiveness in this high-risk group remain unclear. A recent study by Alhumayyd et al provided insight into this issue. However, it has notable limitations, including its retrospective nature, small sample size, and failure to adjust for important confounding factors such as disease severity, hemodynamic status, and platelet function. The study's findings indicated that urgent endoscopy may help decrease the incidence of recurrent bleeding; however, it did not show a clear benefit in terms of mortality. Future research ought to prioritize prospective, multicenter studies that employ standardized protocols and incorporate risk stratification models to better understand the impact of endoscopic treatment for GIB in these patients. Additionally, integrating platelet function assays could improve clinical decision-making. Addressing these research gaps is essential for improving patient outcomes and developing effective guidelines for managing GIB in individuals with thrombocytopenia.