Thrombocytopenia is a condition in which there are a lower than normal number of platelets in the blood. Blood cells are made in the bone marrow. In myeloma, abnormal plasma cells multiply and spread within the bone marrow, eventually crowding out all of the normal blood cells and preventing the bone marrow from working properly.
This means the bone marrow produces fewer blood cells, including platelets. Thrombocytopenia can also occur as a side-effect of some anti-myeloma treatments including thalidomide, bortezomib (Velcade®), lenalidomide (Revlimid®), cyclophosphamide and melphalan.
Mild thrombocytopenia does not always cause symptoms. Some of the more common signs or symptoms of moderate to severe thrombocytopenia include:
- Spontaneous bleeding in the mouth and gums
- Easy or excessive bruising
- Nosebleeds
- A red pinpoint rash (petechiae)
- Prolonged bleeding from cuts
Blood in stools, urine or vomit can be a sign of spontaneous or internal bleeding which can lead to a medical emergency and should be treated right away.
Thrombocytopenia as a complication of the myeloma itself normally begins to improve with anti-myeloma treatment. As
treatment begins to bring your myeloma under control, your bone marrow is often able to recover and will start producing normal amounts of platelets and other blood cells.
You should be vigilant for the signs and symptoms of thrombocytopenia and report them immediately.
Some other self-management tips include:
- Avoid activities that can result in bruising or bleeding e.g. contact sports, body piercing or tattooing
- Take care when brushing your teeth to avoid bleeding of the gums e.g. use a soft toothbrush and take care when flossing
- Take extra care not to cause cuts or wounds to the skin
- Limit your alcohol intake
In the future A drug called eltrombopag, which helps to stimulate the production of platelets, is currently being investigated as a possible supportive treatment for myeloma-related thrombocytopenia.
