Thrombocytopenia in the cancer patient

Thrombocytopenia is commonplace in patients receiving cytotoxic chemotherapy. The trigger level to transfuse platelets is not always absolute. Spontaneous bleeding is unlikely if platelets are >20 x 109/l, but the risk of traumatic bleeding is greater if <40 x 109/l. Most clinicians would transfuse when platelets are <10 x 109/l. However, if there is active bleeding, many clinicians would transfuse if <50 x 109/l.

Careful consideration of the patient's vascular status, clotting status, and disease risks (e.g. gastric carcinoma) will determine the threshold for transfusion in an individual patient. Cross-matching is not required since patients generally receive random, pooled, donor platelets.

Some patients may become refractory after repeated transfusions and HLA-matched platelets should be used. Four units of fresh platelets, (doubled if platelets greater than three days old), should raise the count to >24-40 x 109/l in an adult. Although frequently part of the differential diagnosis of refractoriness, HLA allo-immunization is only one of many causes. Others include the presence of:

♦ Anti-platelet antibodies

♦ Disseminated intravascular coagulation

♦ Concomitant drugs e.g. septrin

♦ Hypersplenism

10 Ways To Fight Off Cancer

10 Ways To Fight Off Cancer

Learning About 10 Ways Fight Off Cancer Can Have Amazing Benefits For Your Life The Best Tips On How To Keep This Killer At Bay Discovering that you or a loved one has cancer can be utterly terrifying. All the same, once you comprehend the causes of cancer and learn how to reverse those causes, you or your loved one may have more than a fighting chance of beating out cancer.

Get My Free Ebook


Post a comment