Thrombocytopenia is too few clot-forming platelets in the blood.

(Pronounced  THROM-boh-SEYE-toh-PEE-nee-ah)

When it develops:
Some chemotherapy agents and/or radiation treatment can damage the bone marrow as cancer cells are killed. This can lead to a decrease in platelet counts. Platelets play an important role in clotting blood, so any time your platelets count drops you are at a higher risk of bleeding. This may occur 7 to 14 days after chemotherapy treatment begins or sooner if patients are taking more than one chemotherapy drug. The effect of chemotherapy on your platelet count builds up over time. Precautions for thrombocytopenia may not be necessary after one course of chemotherapy, but could become necessary after several courses.

You may be have thrombocytopenia if you:

• Have small purplish-red spots on your skin – a condition called petechiae. (peh-TEE-key-aye)
• Have a rash.
• Bruise easily with minor pressure or a small injury.
• Bleed from a wound or from body cavities (mouth, nose, etc)
• Have blood in your stools, urine, vomit or spit.

What you can do

• Brush your teeth gently with a soft-bristle toothbrush or a sponge toothette to clean your teeth and gums; do not floss; avoid mouthwash with alcohol; coat lips with petroleum jelly or lip balm; talk to your doctor before having dental work.
• Do not use rectal thermometers, suppositories or enemas; avoid straining too much with bowel movements; increase fluids to avoid constipation; use stool softener s or laxatives if OK with your doctor, avoid alcohol.
• Use an electric razor; be cautious with tools, scissors, knives, or needles.
• Wear shoes or slippers at all times to protect your feet and do not wear tight-fitting clothing.
• Don’t take aspirin or Advil without checking with your doctor; avoid intramuscular injections.
• Avoid participating in contact sports or sexual activity.

Call your doctor if you have any of these symptoms.· 

• Bleeding that does not stop after you have applied pressure for 10-15 minutes.· 
• A persistent headache, blurred vision or a change in your level of consciousness, decreased attention span, excessive sleeping, confusion and/or difficulty being awakened.· 
• Blood in your urine or your urine appears dark in color.· Blood from your rectum, blood in your stool or your stool is black..

If you have a major injury or start spontaneously bleeding, go immediately to the nearest hospital emergency room. Make sure you inform the doctor that you are receiving chemotherapy and that your platelet count may be low. 

Talk to your medical team about thrombocytopenia and ask how they are monitoring your platelet count and if preventative treatment might be right for you.

What your doctor might do

Platelet transfusion may be recommended and rarely the drug oprelvekin (brand name Neumega) may be prescribed, but it is not appropriate in all cases of thrombocytopenia.

This page was last edited on 01/09/2004
Written by Rachael Myers Lowe, cancerpage.com
Clinical review by Bonnie Pesacov, RN, MS, AOCN