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About Lymphoma

Thrombocytopenia

Our blood is made up of a fluid called plasma, red blood cells, white blood cells and thrombocytes. Thrombocytes are more commonly known as platelets. They were nicknamed platelets because they look like little plates when looked at through microscope. When our platelets (thrombocytes) are too low, it is called thrombocytopenia.

Platelets are cells in our blood that help with clotting. When we cut or bump ourselves, our platelets rush to the area to plug up our wounds to stop bleeding and bruising. They also release chemicals that send signals to other clotting factors to come and help repair the damage. If you have thrombocytopenia, you are more likely to bleed and bruise easily.

On this page:

What do you need to know about platelets?

Image showing blood cells within the bone marrow.
Blood cells, including red blood cells, white blood cells and platelets are made in the softer, spongey middle part of your bones.

Platelets is common term used for the blood cells thrombocytes.

Platelets are made in our bone marrow – the spongey middle part of our bones, and then move into our blood stream.

Our body makes about 100 billion platelets every day! (That’s about 1 million every second). But they only live in our blood for about for about 8-12 days, before dying and being replaced by new platelets.

Platelets respond to chemicals that our damaged blood vessels release. These chemicals activate the platelets so they become sticky and stick the damaged area of the blood vessels, forming a scab. 

Unactivated platelets are not sticky and move through our blood vessels easily without sticking to each other, or the walls of our blood vessels.

How do platelets stop bleeding and bruising?

We bleed and bruise when one of blood vessels gets damaged and the blood leaks out. Some of these blood vessels are very tiny (capillaries), while others are much bigger (arteries and veins). When one of these vessels becomes damaged, they release chemicals that attract and activate our platelets.

Our platelets rush to the area and stick to the damaged area and each. Millions of platelets gather together over the wound to form a plug (or a scab), keeping our blood in our blood vessels and preventing germs from getting into our blood stream.

Many times we may damage these blood vessels – such as tiny capillaries when we blow our nose or brush our teeth, but we don’t bleed because our platelets effectively and very quickly plug up the hole. However, when you are thrombocytopenic, you do not have enough platelets to cover the wound. This can cause bleeding or bruising.

Image showing a bruise on the arm of someone with low platelets

What you need to know about thrombocytopenia

Thrombocytopenia is the medical name for not having enough platelets. It is a common side effect of many lymphoma treatments and puts you at increased risk of bleeding and bruising.

There is nothing you can do to prevent thrombocytopenia, so the important thing is to recognise your risk, and take steps to prevent it being a problem. 

 

Some lotions, creams, medicines and supplements may increase your risk of bleeding. Talk to your doctor or pharmacist about your risk of bleeding and if it safe to take these things. Click on the heading below for more information.

 

Some over-the-counter medicines can increase your risk of bleeding and bruising. Some of these are tablets while others are in creams or lotions. Ask your doctor or pharmacist before taking any of the below over-the-counter medicines.

  • aspirin (aspro, cartia) 
  • ibuprofen (nurofen)
  • melatonin
  • bromelain
  • vitamin E
  • evening primrose
  • aloe.

Many herbs and spices have great health benefits. However, if you have thrombocytopenia, there are some you should avoid. Talk to your doctor or pharmacist before taking supplements with any of the following herbs and spices.

 

  • turmeric
  • ginger
  • cayenne pepper
  • garlic
  • cassia cinnamon
  • feverfew
  • gingo biloba
  • grape seed extract
  • dong quai.

Signs and symptoms of low platelets

Having low platelet levels will not make you feel any different. It is usually diagnosed after a routine blood test shows you have lower levels than normal. Other signs and symptoms you may get include:

  • Bleeding longer than you normally would after minor cuts or scrapes.
  • Bruising more than usual.
  • Nosebleeds or blood on the tissue when blowing your nose.
  • Bleeding gums after brushing your teeth.
  • Bleeding when you go to the toilet.
  • Coughing up blood.
  • If you get a period (menstruate) you may notice it is heavier or lasts longer than usual.
  • Small, red, or purple spots or patches on your skin, this make look a bit like a rash.

Precautions you need to take when thrombocytopenic

Your platelets generally improve with time or platelet transfusions. However, while you are thrombocytopenic there a precautions you need to take to prevent potentially life-threatening bleeding. These are listed below.

  • Use only a soft toothbrush, and brush gently.  DO NO NOT FLOSS unless it has always been part of your routine.
  • Do not play any contact sports or sports where accidental contact can happen.
  • Do not go on theme park rides.
  • No rough play with animals or pets.
  • Avoid using force when blowing your nose.
  • Avoid crispy, chewy and hard foods.
  • Take aperients (laxatives) to prevent constipation so you do not strain when going to the toilet.
  • Remove clutter in your home to avoid bumping, tripping and falls.
  • Avoid using sharp instruments such as knives and tools.
  • If you are having sex, let your partner know it needs to be gentle and use lots of lubricant, -If you are using silicone-based toys or condoms use a water-based lube.  If not using toys or condoms, use a silicone-based lube. 
  • Use sanitary pads rather than tampons during your period.
Report all unusual bleeding or bruising to your medical team.

Treatment for thrombocytopenia

You may not need any treatment for thrombocytopenia. In many cases your platelet levels will increase without intervention over the next few days and weeks. The main thing to do is to take the above precautions.

However, if you are actively bleeding or bruising or your platelet level is considered critical you may need a platelet transfusion. Your doctor may even recommend a platelet transfusion if you are going to have surgery or a procedure that may cause some bleeding. 

A platelet transfusion is when the platelets from a blood donors’ blood have been separated from the rest of the blood, and the platelets are given to you. Pooled platelets are when you get more than one donors platelets in the one bag.

The platelets look a yellowy colour and are given to you through a cannula or central line. A platelet transfusion usually only takes 15-30 minutes, however you may need to wait for them to come from the blood bank.

Image of yellowish coloured platelets haning on an IV pole to be transfused.

Medication review

Your doctor or pharmacist may also want to review your medications. Tell them about all medications you are taking, even if you got them from the pharmacy without a script, or from the supermarket. 

If you are taking any illicit drugs, you should let your doctor know this too. You will not get into legal trouble, and they will be able to factor this into their decision making about your health care.

Wound management to stop bleeding

If you are actively bleeding, place a cold pack over the area and apply firm pressure until the bleeding stops, or you get to the emergency department. The nurse or doctor will assess your wound and choose the right dressing to help stop any bleeding and avoid infection.

Watch - Platelets and blood clotting

Summary

  • Thrombocytopenia is a common side-effect of treatment for lymphoma.
  • Thrombocytes are commonly called platelets, and when these blood cells are low, it is called thrombocytopenia.
  • Platelets are activated by chemicals released from your blood vessel walls when they are damaged.
  • Once activated, platelets stick to the damaged part of the blood vessel, and to each other to form a plug to stop bleeding and bruising.
  • Some medicines, herbs and spices can increase your risk of bleeding. Talk to your doctor or pharmacist about what they recommend.
  • Thrombocytopenia puts you at risk of bleeding and bruising.
  • You may not need any treatment for thrombocytopenia as your platelets will likely increase without medical intervention however, you will need to take precautions as listed above.
  • In some circumstances you may need a platelet transfusion.
  • If you have any questions you can call our Lymphoma Care Nurses, Monday-Friday 9am-5pm Eastern Standards Time. Click on the contact us button at the bottom of the screen for details.

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