Understanding Low Platelets

Quick summary

Think of platelets in the same way you'd think of cornstarch or flour when you mix it in a sauce or stew, and it's easy to see why they're so important: They're the clotting factors that make blood thicken and harden. Without them, bleeding becomes unstoppable and suddenly every minor cut or injury becomes dangerous.

Why does cancer make platelet counts drop?

In most cases, it's not the cancer itself but the treatment that causes low platelets . Chemotherapy can make platelet counts fall because it targets cells that grow rapidly. Tumor cells grow and divide quickly, but so do the cells in the bone marrow that produce red blood cells and platelets. Radiation can also cause a low platelet count (also called thrombocytopenia), especially radiation to the pelvic area, because there's a higher proportion of bone marrow in the pelvic bones. But some cancers, particularly lymphoma and leukemia, can lower platelet production if they spread to the bone marrow.

 

Can low platelet counts be prevented?

There are medications called cell growth factors that can be given along with chemo or radiation to prevent blood counts from dropping. The growth factor that works for low platelets is called oprelvekin (brand name Neumega). There's a risk of side effects with this medication, though, so the doctor will decide whether to prescribe it based on her assessment of the patient's risk of developing a low platelet count. The doctor will also consider whether he has heart problems, because Neumega's side effects include fluid retention and heart palpitations -- both of which can worsen heart conditions. Other side effects include diarrhea and other digestive issues.

More ways to understand low platelets

How long will it take platelet counts to rise again?

That's the big question, and the answer is: probably within three to four weeks. Doctors can't make an accurate prediction because platelet count depends on many factors, including the type of cancer, type of treatment -- particularly the type and dosage of chemo -- and a patient's general state of health. One thing to keep in mind is that a patient's platelet count generally won't drop immediately after chemo; it usually takes a week or two. This is because chemo doesn't kill off the platelets already in the bloodstream, which are mature and aren't dividing rapidly. It kills off the cells forming in the marrow, and therefore there's a delayed response, with the lowest platelet counts (called the nadir) usually occurring seven to 14 days after chemo.

 

After that, a patient's body will begin regenerating platelets at a rate of approximately 10 percent a day. (Platelets have a life span of eight to ten days, so, on any given day, approximately 10 percent are being lost and replaced.) But some types of cancer and some types of trea tment suppress the production of platelets, so the rebuilding process can be much slower.

More ways to understand low platelets

How low do platelet counts need to go before treatment is necessary?

The answer to this question, in most cases, depends on whether the patient is having bleeding problems, because most doctors will treat the symptoms rather than looking only at the platelet count. A normal platelet count is between 150,000 and 450,000 per cubic millimeter, but most people won't experience serious bleeding problems until their platelet count drops below 50,000, and some will function fine with a platelet count lower than that. "Doctors try not to treat to a number because everyone is different and reacts differently," says Andrew Putnam, director of the Palliative Care program at Lombardi Comprehensive Cancer Center and Georgetown University. "If you aren't having problems with bleeding, then the doctor will probably let it go lower and see if the counts recover."

 

What symptoms of low platelet count should I watch for?

Bruising and bleeding that won't stop are the two main signs of a low platelet count. A patient may have frequent nosebleeds or a nosebleed that won't stop. Women who are still menstruating need to watch out for heavy flow that seems like it won't let up. Less common symptoms of a low platelet count are blood in the stool or black, tarlike stools; blood in the urine; or a skin rash of pinprick-size red dots.

If there haven't been any problems with excessive bruising or bleeding, the doctor will probably wait to treat it, but there are still protective steps you should take.


10 months ago, said...

My uncle is 35 years old . His platelets are lowing down again and again .platelets count are 1000 then it is 2000 then 1000 . Their is a bleeding also from his mouth . He has no fever or no weakness in body Eating well sleepin well but don't know what kind of disease is this can you please tell me


about 2 years ago, said...

My brother has bone cancer for 3 years now and lately he's been experiencing frequent fevers and tremors. His platelets are low and I want to know what we can expect.


almost 3 years ago, said...

My mother, who is 85 years old has a count of platelets of 136. Last month she had 148, and before that she had a count of 133. I want to know if for a person of her age this is normal. Lately she has been feeling fatigued and tiresome. Thank you for your information.


about 3 years ago, said...

I am needing surgery and was told my platelets were low. They were 58 and should be 158 (was told) I have no Cancer and 3 months ago had no problems with my white cells. I do have stage 4 liver sirious that has been treated for 6 years. If my platlets were so low I cannot understand why they put me off from June 1o till July 17 to ck them. Could I get worse and I need this back surgery I have been on a walker or in the bed for 8 months and how long is it going to take for me to get back together. I have my blood checked every 6 months and ultra sound, MRI and all is same I am very frightened as I live alone and no reletives and new in neighbor hood and on disibility I can drive but can barely stand to microwave a bowl of soup


over 3 years ago, said...

I am currently and only have 4 wks left of hep c treatment with interferon and ribivirin. My plt count is critical and my dr didn't even mention it. I found out myself after i requested my blood tests. Should i just wait for treatment to end and not say anything or should i tell his office the same people that didnt say anything to me. After reading all info i could my hands on,im sure he dosent know what it is or his staff didnt tell him?


about 4 years ago, said...

I had been treated with radiation for prostate cancer. After nine months one night I started bleeding profusely thru rectum with low platet count of 8000. My doctor transfused mega unit and whole blood. The count came to normal with in 3 days. After two months same thing happened. Then my doctor had a bone marrow biopsy which said that my bone marrow was suppressed that particular day but now has regained platellets to 350 and so would not advise in treatement. I fear this would happen again and if not attended timely would threaten my life. (in my country at certain places where i travel there are no blood transfusion facility. It needs to travel for hours to reach the facility.) Any one can advise that the bone marrow functions properly.


over 4 years ago, said...

To Akalypso I recently found this website. Saw your question. I was diagnosed with multiple myeloma last October. Prior to that, I experienced agitation in my legs and then upper body - gyrating movements akin to Parkinson's. I paced the floors at night. It was as though I had restless leg syndrome - but no "creepy crawly" feelings. No pain, just a lot of agitation. When taken to ER, tests revealed platelet count of 2.


almost 6 years ago, said...

Can a menstrual cycle cause you to have low platelet count when you are passing large amounts of blood clots, during your cycle?


almost 6 years ago, said...

How we can to do the diagnostic of breast cancer?


almost 6 years ago, said...

I'm a Medical Technologist. I work in Medical Laboratory.


about 6 years ago, said...

has anyone experienced pain or agitation from low platelets?


about 6 years ago, said...

what to eat after a serious case of hemorrage dengue?


over 8 years ago, said...

good info easy to understand thanks again