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Oncology
Thrombocytopenia
| Question | Answer |
|---|---|
| Cell line for platelets | myeloid |
| Condition in which there is a deficient number of circulating platelets | thrombocytopenia |
| < 150,000 cells/mm3 or 150 K | thrombocytopenia |
| 50% decrease in platelet count | relative thrombocytopenia |
| s/sx of thrombocytopenia | bleeding |
| s/sx of thrombocytopenia | purpura and/or petechiae |
| s/sx of thrombocytopenia | epistaxis |
| s/sx of thrombocytopenia | hemoptysis |
| Platelet count criteria for thrombocytopenia before high-risk procedures | < 50 x10^3 /uL |
| Platelet count criteria for thrombocytopenia with low-risk procedures such as lumbar puncture | < 20 x10^3 /uL |
| Platelet count criteria for thrombocytopenia | < 10 x10^3 /uL |
| Platelet count criteria for thrombocytopenia and acute hemorrhage | any |
| Invasion of bone marrow by malignancy | deficits in platelet production |
| Marrow destruction by chemotherapy | deficits in platelet production |
| Marrow destruction by infection | deficits in platelet production |
| Marrow destruction by other medications | deficits in platelet production |
| Marrow destruction by radiation | deficits in platelet production |
| Splenomegaly induced thrombocytopenia | increased platelet sequestration |
| Immune thrombocytopenic purpura (ITP) | Increased platelet destruction |
| Disseminated intravascular coagulation (DIC) | Increased platelet destruction |
| Plt < 100K AND Unknown cause | Immune thrombocytopenic purpura (ITP) |
| Related to autoimmune platelet destruction | Immune thrombocytopenic purpura (ITP) |
| Treatment goal of ITP | > 50 x10^3 /uL |
| Heparin Induced Thrombocytopenia | |
| clinical presentation is asymptomatic and/or bruising/bleeding | Immune thrombocytopenic purpura (ITP) |
| Causes medication induced thrombocytopenia | Quinine/quinidine |
| Causes medication induced thrombocytopenia | Sulfonamide antibiotics |
| Causes medication induced thrombocytopenia | Vancomycin |
| Causes medication induced thrombocytopenia | Penicillin |
| Causes medication induced thrombocytopenia | Rifampin |
| Causes medication induced thrombocytopenia | Carbamazepine |
| Causes medication induced thrombocytopenia | Heparin |
| Causes medication induced thrombocytopenia | Abciximab (GPIIb/IIIa inhibitors) |
| Causes medication induced thrombocytopenia | NSAIDs |
| Causes medication induced thrombocytopenia | H2 antagonists |
| Causes medication induced thrombocytopenia | Chemotherapy |
| Causes medication induced thrombocytopenia | Valproic acid |
| Effects any age, affects both genders and is uncertain of cause | Immune thrombocytopenic purpura (ITP) |
| Chemotherapy Induced Thrombocytopenia | Gemcitabine |
| Chemotherapy Induced Thrombocytopenia | Platinum agents |
| Treatment for medication induced thrombocytopenia | D/C offending medicine |
| Treatment for medication induced thrombocytopenia | monitor patient for s/sx of toxicity |
| Treatment for medication induced thrombocytopenia | CBC monitored daily or more frequently depending on severity |
| ITP + (none or mild bleeding) + Plt ≥ 20K | Observation alone |
| ITP + (none or mild bleeding) + Plt ≥ 20K | 1st line treatment |
| ITP + Plt <20K | Should start 1st line treatment |
| ITP + Plt <20K | Consider hospitalization if newly diagnosed |
| Active Bleeding + ITP | Start Corticosteroids and IVIG Transfuse platelets (plt count doesn’t matter) Consider urgent splenectomy |
| 1st line treatment for initial adult ITP | Prednisone x 21 days |
| 1st line treatment for initial adult ITP | Dexamethasone x 4 days |
| 1st line treatment for initial adult ITP | IVIG PRN |
| Active bleeding or Plts < 10 K | Platelet transfusion |
| Treatment for refractory ITP (failing steroids) | Rituximab IV Qweek x 4 wks (test for Hep B) |
| Treatment for refractory ITP (failing steroids) | TPO‑RA (TPO Receptor Agonists) |
| Treatment for refractory ITP (failing steroids) | Splenectomy |
| Treatment for refractory ITP (failing steroids) | Romiplostim |
| Treatment for refractory ITP (failing steroids) | Eltrombopag |
| Treatment for refractory ITP (failing steroids) | Avatrombopag |
| Treatment for chemotherapy induced thrombocytopenia | Platelet transfusion (if plts < 10 K) |
| Treatment for chemotherapy induced thrombocytopenia | Chemotherapy dose redution or delay |
| Treatment for chemotherapy induced thrombocytopenia | Romiplostim |
Created by:
CaristW