Platelets are tiny, colorless cell fragments in the blood necessary for normal clotting. A normal count generally falls between 150,000 and 450,000 per microliter of blood. Many cancer patients, particularly those receiving chemotherapy, experience a drop in these counts, known as thrombocytopenia. Chemotherapy drugs target rapidly dividing cells, which unfortunately includes the healthy stem cells in the bone marrow responsible for platelet production. Low platelet counts increase the risk of bleeding and bruising, sometimes requiring adjustments to the cancer treatment schedule.
Medical Treatments for Raising Platelet Counts
For cancer patients with dangerously low platelet levels, the most direct intervention is a platelet transfusion. This procedure involves infusing donated platelets directly into the bloodstream through an intravenous line. Transfusions are typically indicated for patients with severe thrombocytopenia or those experiencing active bleeding. While transfusions offer an immediate boost to clotting ability, the transfused platelets only circulate for a few days, meaning repeat transfusions may be necessary.
Medical management also involves stimulating the body’s own production of platelets using thrombopoietic growth factors. These medications interact with receptors on bone marrow cells, prompting them to produce more platelets. The drug Oprelvekin, for instance, stimulates megakaryocyte development, the precursor cells to platelets. Newer agents, known as thrombopoietin receptor agonists (such as romiplostim and eltrombopag), are also used. These medications help sustain platelet levels over a longer period by encouraging the bone marrow to recover efficiently.
When thrombocytopenia is caused directly by cancer treatment, the healthcare team may need to adjust the chemotherapy regimen. This adjustment can involve delaying the next cycle of treatment or reducing the dosage of the chemotherapy drug. Modifying the treatment allows the bone marrow sufficient time to recover and regenerate its supply of platelets. Balancing cancer treatment with managing side effects is a routine aspect of oncology care.
Dietary and Nutritional Strategies
While medical interventions are the primary method for treating severe thrombocytopenia, nutritional support plays an important role in sustaining platelet production. Several vitamins and minerals are directly involved in creating blood cells. Specifically, nutrients like Folate (Vitamin B9) and Vitamin B12 are necessary for healthy cell division and maturation, including the development of megakaryocytes.
Patients should incorporate foods rich in folate, such as leafy green vegetables, lentils, and fortified cereals. Sources of Vitamin B12 include lean meats, poultry, eggs, dairy products, and fortified plant-based milk alternatives. Adequate intake of Iron is also necessary, as it contributes to the overall health of the blood-forming system. Iron-rich options include red meat, poultry, and plant sources like pumpkin seeds and pomegranates.
Vitamin C is another supportive nutrient, helping the body absorb iron and playing a role in platelet function. Citrus fruits, bell peppers, tomatoes, and broccoli are excellent sources. Some patients inquire about herbal remedies, such as papaya leaf extract. However, patients must discuss any supplements or herbal extracts with an oncologist, as they can interact with cancer medications or affect clotting mechanisms, potentially causing harm.
Safety Measures During Low Platelet Counts
When platelet counts are low, the focus shifts to preventing injuries and monitoring for signs of internal bleeding. Patients should avoid activities that carry a risk of falling or severe impact, such as contact sports or rough physical labor. Simple precautions like wearing shoes indoors and outdoors can protect the feet from cuts or scrapes.
A careful review of medications is a necessary safety step when platelet levels are low. Patients must avoid over-the-counter pain relievers that impair platelet function or thin the blood, such as aspirin and NSAIDs (like ibuprofen or naproxen). Even common cold remedies or supplements must be cleared by a healthcare provider, as many contain hidden ingredients that increase bleeding risk.
It is important to monitor the body for subtle signs that indicate excessive bleeding. These symptoms include petechiae, which are tiny, pinpoint red or purple spots on the skin. Other warning signs include excessive bruising, prolonged nosebleeds, bleeding from the gums, or any blood in the urine or stool. Any sign of new or worsening confusion, or bleeding that does not stop after applying sustained pressure, requires immediate medical attention.