Thrombocytopenia

Thrombocytopenia is a condition where there is a lower-than-normal number of platelets in the blood. Platelets (thrombocytes) are colorless blood cells that help blood clot. They stop bleeding by clumping and forming plugs during blood vessel injuries. Having a low platelet count could result in easy bruising and excessive bleeding from wounds or bleeding in mucous membranes and other tissues.

Cancers like leukemia and lymphoma can lower the platelet count in the blood and increase your risk of bleeding and bruising. Cancer treatments, such as chemotherapy and radiation therapy, can also contribute to a low platelet count.

Signs and Symptoms of Thrombocytopenia

Thrombocytopenia signs and symptoms may include:

Easy or excessive bruising (purpura)
Fatigue
Bleeding that does not stop after a few minutes
Tiny red or purple dots on the lower legs that resemble a rash (petechiae)
Bleeding from your mouth, nose, or when you vomit
Urine that is red or pink
Stools that are black or bloody
Enlarged spleen
Bleeding from your vagina when you are not having your period (menstruation) and/or unusually heavy menstrual flows
Head or vision changes such as bad headaches, feelings of confusion, or severe sleepiness.

Signs and symptoms of thrombocytopenia, or a low platelet count, can appear suddenly or over time. Mild thrombocytopenia often has no signs or symptoms. Many times, it is found during a routine blood test. If you notice any of these changes, it is important to tell your oncology team.

Diagnosing Thrombocytopenia

Your doctor will diagnose thrombocytopenia based on your medical history, a physical exam, and blood test results. A hematologist — a doctor specializing in diagnosing and treating blood diseases and conditions — may also be involved in your care.

Blood tests. A complete blood count determines the number of blood cells, including platelets, in a sample of your blood.
Physical exam, including a complete medical history. Your doctor will look for signs of bleeding under your skin and feel your abdomen to see if your spleen is enlarged. He or she will also gather information regarding any illnesses you’ve had and the types of medications and supplements you've taken recently.

Depending on your signs and symptoms, other tests and procedures may be recommended by your doctor. Once thrombocytopenia is diagnosed, your doctor will begin looking for its cause, as thrombocytopenia often improves when its underlying issue is treated.

Treatment Options for Thrombocytopenia

Treatment for thrombocytopenia depends on its cause and severity. If your condition is mild, you may not need treatment. If your thrombocytopenia is severe, your doctor may prescribe treatments such as medication, blood or platelet transfusion, or a splenectomy.

Medicines

Your doctor may prescribe corticosteroids, also called steroids for short. Steroids may slow platelet destruction. These medications can be given through a vein or by mouth. One well known example of this type of medicine is prednisone.

Your oncologist may prescribe immunoglobulins (also known as antibodies) or medicines to block your immune system. These medicines are given through an IV or given as an injection under your skin. He or she also may prescribe other medicines to help your body make more platelets.

Heparin-induced thrombocytopenia (HIT) is an adverse reaction to heparin therapy, where the body forms blood clots versus preventing them. When diagnosed with HIT, stopping heparin therapy will not resolve the issue. Oftentimes, another medication will be prescribed to prevent blood clotting.

Blood or Platelet Transfusions

Blood or platelet transfusions are used to treat people who have active bleeding or are at a high risk of bleeding. During this procedure, a needle is used to insert an intravenous (IV) line into one of your blood vessels. Through this line, you receive healthy blood or platelets.

Splenectomy

A splenectomy is a surgery to remove the spleen. This surgery may be used if treatment with medication does not work. This surgery is mostly used for adults who have immune thrombocytopenia (ITP); however, medicines are often the first course of treatment.