Thrombocytopenia Is Associated With High Levels Of Fatigue In Myelofibrosis
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Jeanne M. Palmer, MD, discusses a retrospective analysis of the PERSIST-1 and PAC203 trials, the symptoms that were analyzed across patient populations, and what the findings from this research indicate about the relationship between low platelet counts and symptoms such as fatigue in myelofibrosis.
Jeanne M. Palmer, MD
Patients with myelofibrosis who have isolated thrombocytopenia have high symptom burdens, including higher levels of fatigue than those in patients with myelofibrosis with isolated anemia, according to Jeanne M. Palmer, MD.
A retrospective analysis of the phase 3 PERSIST-1 and phase 2 PAC203 trials that was presented at the 2022 ASH Annual Meeting revealed that patients with myelofibrosis with low platelet counts had higher total symptom scores than those with low hemoglobin counts. Specifically, patients with low platelet counts had TSS v1.0 and 2.0 of 18.6 and 29.0 vs 12.2 and 24.7 in patients with low hemoglobin counts in the PERSIST-1 and PAC203 cohorts, respectively.1
Weve learned a couple lessons from this research, Palmer said in an interview with OncLive®. First, understand that the fatigue and some of the other symptoms associated with myelofibrosis may not only be related to anemia. Second, thrombocytopenia these patients, and maybe in cytopenic patients in general.
Reducing Your Risk Of Bleeding
If you have very low platelet levels, there are some precautions you can take to reduce your risk of bleeding.
Food, drink and medicines
- Try to limit how much alcohol you drink as it can make bleeding worse.
- Check with your doctor before taking any over-the-counter medicines, supplements or herbal remedies.
- Do not take aspirin or other blood-thinning medicines unless your doctor has told you to.
- Avoid using enemas or suppositories.
Activities
- Be very careful when you use knives, scissors or other sharp tools.
- Avoid high-impact sports and contact sports .
- Wear gloves and clothes that cover your skin to help protect you from scratches and cuts if you do activities where you might injure yourself .
- Wear shoes or slippers to protect your feet from injuries.
Hygiene
- Brush your teeth gently using a soft toothbrush. Avoid flossing to prevent your gums bleeding.
- Be gentle when blowing your nose to help prevent nosebleeds.
- Use an electric razor instead of wet shaving.
- Use sanitary towels instead of tampons.
- Use a water-based lubricant during sex.
Other Symptoms Of Low Platelets:
- Constant and abnormal menstrual flow
- Bleeding profusely during surgery
- Presence of blood in the urine or feces
- Prolonged bleeding from cuts or injuries to the skin
- Excessive and recurrent bruising
- Spontaneous bleeding from the gums or nose
- Superficial bleeding on the skin that appears as a rash of small red spots, usually on the legs.
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Treatments For Immune Thrombocytopenia
If your thrombocytopenia is caused by autoantibodies destroying your platelets, platelet transfusions usually do not help. Instead, the treatment for this type of thrombocytopenia aims to reduce the number of autoantibodies being made, or stop your platelets being destroyed.
In some cases, treating your lymphoma is also effective at treating immune thrombocytopenia. Other treatment options include:
- steroids, which reduce the activity of your immune system
- immunoglobulin replacement therapy, which stops cells in your spleen destroying platelets
- rituximab, which targets the cells that make antibodies
- having your spleen removed
- treatment with other drugs that dampen your immune system .
If your platelet level still doesnt improve, you might need treatment with a drug called a thrombopoeitin receptor agonist. Thrombopoietin is a chemical messenger made in your liver. It tells your bone marrow to make more platelets. Thrombopoeitin receptor agonists are medicines that mimic the effects of thrombopoietin.
You might be treated with a thrombopoietin receptor agonist if you have immune thrombocytopenia that hasnt responded to other treatments and you have a high risk of bleeding.
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Associated Symptoms Of Bleeding After Menopause
These are common symptoms you might encounter along with vaginal bleeding after menopause:
- Cramping or Abdominal Pain
- Rapid heart rate or fast heart rate as a result of hypovolemia
- Sudden weight gain or loss
- Fever and chills with ill feeling associated with infection
These symptoms indicate presence of further problems in a woman and these should not be ignored. Early detection of underlying causes is important to immediately implement certain treatments.
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Stopping Treatments Or Medications That Cause Leukopenia
Sometimes you may need to stop a treatment to give your body time to make more WBCs. Your blood cell counts may naturally rise when treatment like radiation is over or between chemotherapy sessions. The amount of time it takes for WBCs to replenish varies from person to person.
If youre taking a medication that causes leukopenia, your doctor may adjust the dose that youre taking. They may also recommend switching to a different medication, if possible.
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How Do Platelets Stop Bleeding
If damage occurs to the wall of a blood vessel, the vessel exposes a substance that activates platelets. Activated platelets trigger further events that bring in more platelets, and a blood clot starts to form. This serves to plug any leak.
Activated platelets also release sticky proteins to help form the clot. A protein known as fibrin forms a mesh of threads that holds the plug together.
A platelet count measures the concentration of platelets in the blood. A technician will carry this test out in a laboratory.
A normal platelet count is 150,000450,000 platelets/µl . When the number of platelets is low, this concentration reduces.
Females usually experience a platelet count that varies slightly during the menstrual cycle and can fall near the end of pregnancy.
The following platelet counts
two types of bone marrow tests: a bone marrow aspiration and a bone marrow biopsy. Both tests require a doctor to use a needle to take a sample of the bone marrow for examination. Aspiration involves the collection of a small amount of fluid, whereas a biopsy involves the collection of some soft tissue.
A doctor may diagnose thrombocytopenia after ruling out other causes of a low platelet count.
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Changes To Your Medicines
Some medicines, such as some antibiotic and antiviral medicines, can cause thrombocytopenia. Other medicines, such as blood-thinning treatments and some drugs you can buy without a prescription can increase your risk of bleeding if you have thrombocytopenia. Your medical team will check what medicines you are taking and will stop or adjust the dose of any that might be affecting your platelet count or your risk of bleeding.
If you are having chemotherapy and your platelets are very low, your chemotherapy dose might be reduced, or you might have a longer break between treatment cycles to give your platelet count time to recover. Sometimes, your chemotherapy regimen might be changed.
Natural Treatments For Low White Blood Cell Count
Although it can be scary to know that your bodys defenses are lowered, leukopenia is far from an incurable problem. Along with conventional medications and treatments, there are natural remedies for leukopenia. By bolstering the blood marrow and dealing with potential causes of the low white blood cell count, you can get your immune system back on track.
Improved Diet: Keeping to a balanced diet, particularly one rich in vitamins like B12 or folate, is a good leucopenia home remedy and can help keep your bone marrow stocked with the nutrients it needs to build new leukocytes. Fish, dairy, beans, grains, green veggies, and tofu are all recommended for these two nutrients, and your doctor may advise you to take vitamins to supplement this low white blood cell count diet.
Medication Adjustment: As mentioned above, some medicines can cause leukopenia. Its best to stick with some, like chemotherapy, but if you are taking antihistamines, antibiotics, or other comparatively minor medications then you should talk to your doctor about possible alternatives or changes to your dosage.
Steroids: Although we focus on natural health treatments at Doctors Health Press, some doctors may prescribe steroids to treat low white blood cell count. Steroids can be used to send extra instructions to the bone marrow that encourages it to boost white blood cell production.
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Symptoms Of Low Blood Platelet Count In The Elderly
Symptoms of Low Blood Platelet Count in the Elderly Excessive Bleeding, 44 ] Alternatively, You may have visited the doctor to address anotherHow to Treat ThrombocytopeniaThe treatment you will receive for thrombocytopenia ultimately depends on the severity and cause of the condition.If there is no excessive bleedingHandling A low-platelet CountIf youve noticed some unexplained bruising that seems to be taking a very long time to heal
Treatment For Low Platelet Count
Low platelet count is not something that should be taken lightly or ignored, and if you find that you are suffering from this condition you need to make sure you get treatment right away.
First, the doctor will need to figure out exactly why you are suffering from low platelet counts.
If the cause for the low platelet count is an infection they will likely give you supplements to raise the number of platelets along with the antibiotics and other medication that you are taking.
There are other treatments as well, one is Corticosteroids.
Corticosteroids usually include Dexamethasone or prednisone and are typically prescribed to raise a patients platelet count.
The patient has to take it once a day and it usually comes in the form of a pill or tablet.
With this medication, an increase or at the very least, normalized, the platelet count is generally seen within 2 weeks of prescribing the medicine, especially with high-dose dexamethasone.
However, the dosage will likely be reduced gradually over the next 4 to 8 weeks.
In some cases, this treatment may have to be repeated, but in most cases, once the platelet count is normal, the patient just gets better eventually as energy levels come back to normal.
IVIG or Intravenous Immuno-globulin is another effective treatment, especially if the platelet count does not come up with prednisone or if the person is not able to tolerate steroids.
Surgery is one of the less taken options for a low platelet count.
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When Should You Worry About A High Platelet Count
If you have had a blood test result that indicates a high platelet count, ask your doctor about the meaning of your results and about any precautions or treatments you should take.
Seek emergency medical treatment for symptoms of blood clots or uncontrollable bleeding. However, complications from thrombocytosis can be rare.
What Are The Complications Of Thrombocytopenia
People with severe thrombocytopenia are at risk for significant internal and external blood loss, or hemorrhage. Internal bleeding into the digestive tract or brain can be life-threatening.
Having a splenectomy makes you more susceptible to infections. Your spleen is part of your immune system. It helps your body fight off germs. For this reason, patients who have to have their spleen remove are given several vaccinations to help prevent infection.
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Fatigue: Is Chitosan Helpful
Low platelet causes fatigue. Switch to chitosan for a natural cure that works at the root cause. Apart from hemostatic properties, chitosan is also used as a fat blocker to treat obesity, high cholesterol, and tired blood anemia which includes loss of strength and fatigue.
It is used as medicine in the form of a capsule in form of a supplement that is good for health. Just like we take mineral and vitamin supplements it is used for the same. Let us explore the benefits.
Why Is Knowing Their Count Important
It is important to know your platelet count, as well as the count of your other blood cells because they can show how your bone marrow is working, and it can also show how your body reacts if it goes through a traumatic experience.
The number of references, meaning the number the world uses to say the platelet count is okay, is between 150,000 to 400,000 per microliter of blood. If by doing blood work your platelet count comes within those numbers, it means they are functioning normally.
If they count less than 150,000, it means that your platelet count is low and u
You have a condition called thrombocytopenia. In the most serious situation, the platelet count can reach below 10,000, which is called severe thrombocytopenia.
On the other hand, if it shows that the count is higher than 400,000, this means your platelet count is higher than it should be, a condition called thrombocytosis.
What is important to know is that, even if their count is low, the ones that exist are executing their function normally, it is just that if you dont have enough of them in your body, they wont be able to do what they are meant to do as well as they would if the platelet count was normal.
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After Starting Treatment How Long Does It Take For My Platelet Count To Start Going Up
It depends on what type of treatment you will do to get your players up. Since many types of treatment can be done for it, it is up to you and the doctor to decide the one that fits you best. If it is done through medication it can take a little longer, you most likely be taking the tablets between 6 and 10 weeks, but the first results will be noticed around 2 weeks after you start the medication.
The side effects that can come from it are sleeping problems, feeling bloated, the surge of acne, possible weight gain, peeling of the skin, and lower bone density. But if you both decide you are doing a treatment through an intravenous method, although it will make you go to the clinic every day between 1 and 5 days, your platelet count will start going up faster, although you might feel some side effects such as headache, nausea, and fever.
What To Do If You Develop An Infection
If you develop an infection, your doctor will order medications to treat the infection. Depending on the cause and severity of the infection, the medications may be given either by mouth or through a vein using an intravenous catheter. If you require IV medications, accommodations can be made for you to receive them in our office or possibly at home. Some patients require admission to the hospital in order to effectively treat their infection.
If necessary, your oncologist may decide to delay further treatments until your white blood cell count has returned to normal levels and/or you are free of infection.
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How Is Itp Treated
For most children and adults, ITP is not a serious condition. Acute ITP in children often goes away on its own within a few weeks or months and does not return. For a small number of children, ITP does not go away on its own, and the child may need treatment.
Chronic ITP varies from person to person and can last for many years. Even people who have serious types of chronic ITP can live for decades. Most people who have chronic ITP can stop treatment at some point and maintain a safe platelet count.
Treatment depends on your platelet count and whether you have any symptoms. In mild cases, you may not need any treatment, and your provider will monitor your condition to make sure that your platelet count does not become too low. If you need treatment, your treatment plan may include medicines and procedures. If your ITP was caused by an infection, treating the infection may help increase your platelet count and lower your risk of bleeding problems.
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What Can Cause A Low Platelet Count
There are several common causes, including:
Chemotherapy. Some types of cancer medications, such as chemotherapy, damage bone marrow. This is the tissue inside your bones where your body makes platelets. A low platelet count from chemotherapy is usually temporary. It is rare that chemotherapy permanently damages bone marrow cells.
Radiation therapy. Radiation therapy does not usually cause a low platelet count. But your platelet levels may go down if you receive a large amount of radiation therapy to your pelvis or if you have radiation therapy and chemotherapy at the same time.
Antibodies. Your body makes proteins called antibodies. They destroy substances that may harm you, such as bacteria and viruses. But sometimes the body makes antibodies that destroy healthy platelets.
Specific types of cancer. Certain cancers such as leukemia or lymphoma can lower your platelet count. The abnormal cells in these cancers can crowd out healthy cells in the bone marrow, where platelets are made.Less common causes of a low platelet count include:
Cancer that spreads to the bone. Some cancers that spreads to the bone may cause a low platelet count. The cancer cells in the bones can make it difficult for the bone marrow inside of bones to make platelets.
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What Are Blood Platelets
Blood platelets are part of the blood. The human blood is decided between white, red blood cells and platelets. All of them are made in the bone marrow, a semi-solid tissue found within the bones.
Once they are formed, two-thirds of the platelets produced are released into the bloodstream. The other third is stored in the persons spleen. Each platelet cell usually lasts from 7 to 10 days in the human body, with that, we get the notion that it needs to be in constant production.
The main function of the blood planet is to help your body heal when it gets an injure, since they are responsible for starting the process of the blood clot, whenever you get a cut or a bruise, they are the ones that will start the process of slowing down the bleeding by clotting the injury.
