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.
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.
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 treatment suppress the production of platelets, so the rebuilding process can be much slower. Continue reading ‘Understanding Low Platelets’ »
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