Managing a Low Platelet Count (Thrombocytopenia)
Platelets, also called thrombocytes (THROM-boh-sites), are fragments of bone marrow cells that are found in the circulating blood and are critical in stopping bleeding. Platelets, along with other blood components, rush to the site of an injury and work to form a blood clot, which is necessary to stop the bleeding. A low platelet count is referred to as thrombocytopenia. Thrombocytopenia is a common side effect of chemotherapy.1,2
Causes of a Low Platelet Count—Thrombocytopenia
Normally, there are billions of platelets in the blood; however, certain chemotherapy drugs can cause thrombocytopenia.2 Chemotherapy works by destroying cells that grow rapidly, such as cells in the bone marrow that generate platelets.3
A low platelet count typically occurs 6 to 10 days following administration of chemotherapy and continues for several days before the number of platelets in the blood increases to an adequate level. Infrequently, you may also experience thrombocytopenia from other medications or as a consequence of your cancer.3
Monitoring Your Platelet Count
A low platelet count puts you at risk of certain side effects. Bleeding is the most important:1
- If you do not have enough platelets to form a clot, your body will not be able to stop bleeding.
- Even a small cut can cause you to lose a dangerous amount of blood.
- The fewer platelets you have in your blood, the more susceptible you are to experiencing bleeding.
Another reason thrombocytopenia is important is that, in some cases, it can be severe enough that chemotherapy treatments may need to be delayed or the chemotherapy dose reduced. When patients develop a low platelet count, doctors may have to delay treatment or reduce the doses of the chemotherapy until the platelet count has increased.4
Chemotherapy dose reductions and treatment delays may reduce the chance for achieving optimal results in patients with certain kinds of cancer.
It's important to stick to a schedule of treatment. Find out more about chemotherapy cycles and schedules.
If you have a severely low platelet count, you may require a blood transfusion of platelets and, occasionally, admission to the hospital until the platelets return to sufficient levels in the blood to prevent bleeding.4 A platelet transfusion is the addition of platelets into your blood from another person who has donated their blood. Any transfusion carries the risk of complications, which include infection and allergic reactions that may range from mild to life-threatening.5 Ask your doctor to explain the risks and benefits of platelet transfusions and the various options for treating low platelet counts.
Before you begin treatment, it is important to learn how best to manage blood-related side effects. Your first step should be to understand CBC, or complete blood count.
Lowering Your Risk of Bleeding
If your platelet count is low, you should try to avoid situations that may cause injury or bleeding.1
- Do only mild, low-impact activity for exercise, such as walking or swimming.
- Shave with an electric razor instead of a blade.
- Use a soft-bristle toothbrush.
- Be careful not to bump into things which can causing brusing or bleeding under the skin.
It is important to know that, in addition to blood-related side effects, chemotherapy can result in other side effects.
1. Chemotherapy and you. National Cancer Institute. Updated May 2007. NIH Publication No. 07—7156. http://www.cancer.gov/cancertopics/chemotherapy-and-you.pdf. Accessed June 4, 2010.
2. What are the possible side effects of chemotherapy? American Cancer Society website. Updated June 17, 2009. http://www.cancer.org/docroot/ETO/content/ETO_1_4X_What_Are_The
_Side_Effects_of_Chemotherapy.asp?sitearea=ETO. Accessed June 4, 2010.
3. What is thrombocytopenia? Caring4Cancer website. Updated November 5, 2007. http://www.caring4cancer.com/go/cancer/effects/common/lowplatelet-count-thrombocytopenia.htm. Accessed June 4, 2010.
4. Elting LS, Rubenstein EB, Martin CG, et al. Incidence, cost, and outcomes of bleeding and chemotherapy dose modification among solid tumor patients with chemotherapy—induced thrombocytopenia. J Clin Oncol. 2001;19:1137—1146.
5. Kiefel V. Reactions induced by platelet transfusions. Transfus Med Hemother. 2008;35:354—358.
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