Clinical Pharmacy Discipline,School of Pharmaceutical Science,University of Sains Malaysia,Malaysia
Received date: November 16, 2013; Accepted date: November 19, 2013; Published date: November 22, 2013
Citation: Hassan BAR (2013) Role of Cancer and Chemotherapy in the Incidence of Thrombocytopenia. Pharmaceut Anal Acta 4:e157. doi: 10.4172/2153-2435.1000e157
Copyright: © 2013 Hassan BAR. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Thrombocytopenia is a term used to indicate unusual reduction or drop in platelets numbers. These platelets play a major role in clot formation during bleeding in order to block blood lost. Therefore, a reduction in platelet number will mainly lead to incidence of bleeding, which ranges from mild bleeding from small blood vessels to severe bleeding from large blood vessels. Severe bleeding in the presence of severe thrombocytopenia or when is coupled with other clotting disorders can lead to serious morbidity or death. Thrombocytopenia is a common problem experience by cancer patients, which usually is a result of the use of conventional chemotherapy, and at times, is a dose limiting factor for chemotherapy administration. About 10-25% of solid cancer patients (specifically: breast cancer, ovarian and germ cell) who were treated with intensive chemotherapy suffer from incidence of thrombocytopenia. Even though, incidence of thrombocytopenia among acute leukemia patients is higher than its incidence among other types of cancer [1-8].
The normal range of the platelets is between 150,000 and 450,000 cells per microliter of blood (i.e. 150-450×109/L), while thrombocytopenia could be classified into three levels as follows:
1. ild thrombocytopenia if platelets count <150 and ≥ 100×109/L.
2. oderate thrombocytopenia if platelets count<100 and ≥ 50×109/L.
4. Association of Thrombocytopenia with Chemotherapy
Thrombocytopenia is a harmful side effect of chemotherapy, since it will cause incidence of bleeding among solid cancer patients who were treated with chemotherapy from vital organ mainly the brain. Chemotherapies, specifically the antimetabolites and alkylating agents, caused thrombocytopenia by various mechanisms, either by suppressing megakaryopoiesis, i.e. bone marrow suppression or by direct damaging of the platelets [7,11-13].
The relationship between hemorrhage and thrombocytopenia in leukemic patient was first described in 1962. While among solid cancer patients, presence of thrombocytopenia was reported later . Among those patients, i.e. solid cancer patients, the main cause for incidence of thrombocytopenia is its metastasis to bone marrow. The most frequent types of solid tumors that metastasis to bone are breast, lung and prostate cancers. These cancers when metastasized to bone marrow will lead to bone marrow suppression, resulting in neutropenia and thrombocytopenia with serious morbidity and mortality . Even though the incidence of hemorrhage among solid cancer patients still consider low when it is compared with hematological malignant, unless all the above characteristic are all present .
Therefore, it is an obligate and/or recommended subject for the ongoing on preclinical studies to focus on the incidence of thrombocytopenia among cancer patients.