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- Question: What is the significance of a low platelet count, and what can we do to make it go back up? It came down because of a chemotherapy.
Platelets are one of the three main types of blood cells and are
responsible for the blood clotting mechanism in response to bleeding. Therefore, a low platelet count (thrombocytopenia) may lead to easy or excessive bleeding. Generally a platelet count of less than 10,000 per microliter can lead to spontaneous bleeding and hemorrhage. I belive that prophylactic platelet transfusion at 10,000 to 20,000 platelets per microliter is appropriate for chemotherapy related thrombocytopenia. Another option is to reduce the dose of chemotherapy, if possible. Thrombopoietic agents which stimulate the growth of platelets have been used. Interleukin 11 (IL-2) is clinically available but its use is limited due to side effects. A new recombinant human thrombopoietin is under trial. There are many other reasons for thrombocytopenia such as impaired production due to bone marrow disease, increased destruction as in immune disorders including idiopathic thrombocytopenic purpura(ITP), thrombotic thrombocytopenic purpure (TTP), infections, sequestration by enlarged spleen due to different diseases, for example, lymphoma, heparin and other drug induced. Treatment depends upon the cause. Most of the drug induced thrombocytopenia are self limiting and improve after removal of offending drug. In persistant thrombocytopenia, a full evaluation by an experienced internist or hematologist is recommended.