Tranexamic acid has the potential to be a pharmacologic adjunct for the prophylaxis of hemorrhagic complications occurring in the oncology population. The studies and cases reviewed here suggest that tranexamic acid administration may be a therapeutic option for bleeding prophylaxis in APL where enhanced fibrinolysis accompanies the disease state. Because of the lack of a control in these reports, and the small sample size, it is not possible to extrapolate these conclusions regarding the efficacy of tranexamic acid in preventing hemorrhage in the larger thrombocytopenic oncology population. However, these reports concluded that its administration is safe, with few adverse effects and no thromboembolic events noted. A large, well-designed, controlled clinical trial is needed before a recommendation for the routine use of tranexamic acid in the oncology population can be established.