In the NIH-funded ‘American Trial Using Tranexamic Acid in Thrombocytopenia (A-TREAT)’ trial, UNC was one of 3 participating clinical centers to enroll patients with platelet transfusion-dependence due to therapy for hematologic malignancies. Between 2016 and 2020, 337 patients were randomized in a double blind fashion to tranexamic acid (TXA) or placebo. Ultimately, no benefit of TXA on bleeding outcomes was observed. Drs. Nigel Key and Brandi Reeves were co-authors on this study. In an accompanying ancillary laboratory study that was also NIH-funded, ‘home grown’ plasma assays of fibrinolysis developed in Dr. Key’s lab by Dr. Anton Ilich were used to explain why TXA may have been ineffective in this clinical scenario. Dr. Alisa Wolberg was a co-author on this study. (https://doi.org/10.1182/bloodadvances.2022008255)