When is the platelet count serious

[Marilyndw8]

When is the platelet count to be considered dangerous or very serious? We discovered that my husband’s count was 48K in Jan , today he had a CBC done and his count was down to 16K. What are some things we need to be asking his doctor, what avenues should we be trying to follow? He was started on prednisone today 40 mg 2 x a day. and will have another CBC on Fri.

Thanks for all your answers

[riley]

I just happened to read a great post by Neil on page 5 of this forum that addresses some of your questions. The subject is: Low Platelets and transfusions. I hope it helps!

[Terri]

Neil is our Forum expert, if you have technical questions you can be assured he will answer them.

Marilyn My husband when first dx had plts in the 20’s we have done some alternative therapies which I think is helping and have to get back to some of them like the fresh juicing that we have kind of gotten away from.
I hope your Husbands next counts are better.

[Suzanne]

As I remember the transfused platelets for me when they went under 10. Some people can tolerate lower counts then others. Watch for bruising and bleeding.

[ButchL]

I think they worried about it under 20 for my wife and transfused at 10.

[Neil]

Hi Marilyn,
Platelet problems can be difficult to deal with, but there are some thoughts that might help.
He should be seeing a hematologist experienced in treating low platelets! This is very important! Make certain he has such a doc on his team.
The equipment used to measure platelets is accurate within 15,000 units on counts between 50,000 and 500,000. When counts get very low the accuracy is suspect. It takes a series of CBCs to finally get a feel for the actual level.
The presence of symptoms is very important! For example: My platelets have been in the 10,000 range for about 4-5 years. I do not present symptoms of low platelets. Does he have any bruising, bleeding or petechiae? Hopefully no.
When my counts get around 3000 – 5000, my doc has them counted manually. They have always come back at the 10,000 level.
I have had 2 platelet transfusions. One when I needed dental surgery and another when I had a hernia repair.
If platelet tx are necessary, make sure he gets irradiated platelets and they come from a single donor. A patient can receive a limited number of platelet tx till he becomes refractory to them and they do not work. Irradiation and single donor platelets will prevent downstream problems and extend the time tx will be effective.
At present there are no drugs that really grow platelets. Steroids like prednisone help some. My doc claims steroids provide an “artificial” boost. He said there are red and white cells along with platelets in ones tissues and the lining of ones veins and arteries. Steroids release these cells into the blood stream where they become counted. Question is for how long?
How is his Red cell count? If his hematocrit is below 37 there is a very small possibility Procrit might help. Procrit is used to boost red cell counts. In a very few cases and I am one of them it also tends to increase my white and platelet counts also—for a short time. I noticed an increase in WBC and platelets when I got a CBC between shots. This has been happening for 19 months. It could be worth discussing with his doc.
Have him stay away from power tools and drive very carefully.
I have been dealing with this for 8 years and have been very fortunate. Hope he can do as well.
Let us know if MDS is confirmed. If so I have some good info that can help to get up to speed with an understanding of what is happening to his marrow/cells
All of the above should be discussed with his doc to see if it applies in his situation.
Neil

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