Materiały źródłowe

• #1 Screening and Prevention of Thrombocytopenia | Hematology-Oncology Associates of CNY

  https://www.hoacny.com/patient-resources/blood-disorders/what-thrombocytopenia/screening-and-prevention-thrombocytopenia

  Whether you can prevent thrombocytopenia depends on its specific cause. Usually the condition can’t be prevented. However, you can take steps to prevent health problems associated with thrombocytopenia. For example: […] Avoid heavy drinking. Alcohol slows the production of platelets. […] Try to avoid contact with toxic chemicals. Chemicals such as pesticides, arsenic, and benzene can slow the production of platelets. […] Avoid medicines that you know have decreased your platelet count in the past. […] Be aware of medicines that may affect your platelets and raise your risk of bleeding. Two examples of such medicines are aspirin and ibuprofen. These medicines may thin your blood too much. […] Talk with your doctor about getting vaccinated for viruses that can affect your platelets. You may need vaccines for mumps, measles, rubella, and chickenpox. You may want to have your child vaccinated for these viruses as well. Talk with your child’s doctor about these vaccines.

• #1 Low Platelet Count (Thrombocytopenia)

  https://www.healthline.com/health/thrombocytopenia

  If you are at risk of developing a low platelet count, scheduling regular doctors visits will help you pay attention to potential signs and symptoms. […] If you are at risk of developing a low platelet count due to an underlying condition or medical history, your healthcare professional may recommend that you take prevention measures. These may include: […] avoiding activities with a high risk of bleeding or bruising (i.e., contact sports) […] limiting alcohol consumption […] making dietary changes […] stopping or switching medications that affect platelets, including aspirin and ibuprofen […] getting certain types of vaccinations […] avoiding toxic chemicals.

• #1 Early Detection & Prevention

  https://pdsa.org/detection-prevention

  No one knows what causes the immune system to mount an attack on platelets and, unfortunately, it is not known how to prevent the onset of ITP. […] Possible early indicators of ITP are listed below along with several tips for living a healthy lifestyle in an effort to assist with prevention. […] A healthy diet and lifestyle is undeniable for anyone, but can be especially helpful for those with ITP. While there’s no single diet or regimen that will relieve the symptoms of ITP, you can support your immune system by making your lifestyle a healthier one. […] Maintain adequate levels of both folic acid and vitamin D. Diet and supplements have been reported to have a positive effect on both, but be sure to consult your doctor before taking any supplements. […] Avoid environmental toxins and other substances that can cause low platelets.

• #1 Thrombocytopenia | Blood Disorders

  https://health.ucdavis.edu/conditions/thrombocytopenia

  Its not possible to prevent all thrombocytopenia causes. But some are within your control. […] Take extra precautions to avoid infections, like washing your hands and disinfecting high-touch surfaces. […] Vitamin B12 and folate help your bone marrow produce platelets. You can find these nutrients in leafy greens, beans and lean proteins like fish. […] If you need medications, talk to your provider about the safest options. Certain antibiotics, blood thinners and anti-inflammatories can affect platelet count.

• #1 Low Platelet Tips

  https://www.virginiacancer.com/treatment-tips/low-platelets/

  There are several precautions to follow to prevent injuries that may result in bleeding. […] Avoid strenuous activity, contact sports, lifting heavy objects, training to cough, forceful nose blowing, or constipation. […] Avoid medications (see below) that affect blood clotting (unless approved by your doctor). […] Avoid procedures that may cause a break in the skin. Avoid rectal exams, vaginal exams, vigorous thrusting during sexual intercourse, enemas, suppositories, douches, tampons, vaginal or rectal applicators, rectal thermometers, dental exams, surgeries, etc. […] Take special precautions with personal hygiene. […] Avoid falls in the shower or tub by using slip guard mats. […] Use stool softeners to avoid hard bowel movements that may cause injury to the rectum.

• #1 Thrombocytopenia: Evaluation and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0900/thrombocytopenia.html

  Prophylactic platelet transfusions are recommended for patients with platelet counts less than 10 103 per L or at higher counts with signs of bleeding. […] Patients should have a minimum platelet count of 40 to 50 103 per L for most major invasive procedures and surgeries. […] Platelet transfusions are often used in patients with severe thrombocytopenia to treat or prevent acute hemorrhage. Based on multiple trials involving patients with hematologic disorders and those undergoing hematopoietic stem cell transplantation, the American Society of Clinical Oncology clinical practice guideline update and the Cochrane Database of Systematic Reviews recommend prophylactic platelet transfusion when platelet counts are less than 10 103 per L, or at higher counts with signs of bleeding. […] The 2016 American College of Sports Medicine guidelines recommends that for patients with platelet counts from 20 to 50 103 per L, exercise should be limited to resistance training using elastic bands, stationary cycling, range-of-motion exercises, and walking. Vigorous exercise, contact sports such as boxing and football, and activities with increased trauma risk such as gymnastics are contraindicated with platelet counts less than 50 103 per L.

• #1 Thrombocytopenia (Low Platelet Count): Definition, Causes, Symptoms, and Treatment

  https://www.webmd.com/a-to-z-guides/thrombocytopenia-causes-treatment

  If your platelet count isn’t too low, you might not need treatment. […] To prevent bleeding when your platelet count is low: Don’t take medicines that can affect how well your platelets work, like aspirin and ibuprofen. […] Limit how much alcohol you drink, because it can make bleeding worse. […] Don’t take part in contact sports, like football or boxing, in which you might get injured. […] Use a soft toothbrush to protect your gums. […] Wear a seatbelt when you’re in a car, and put on gloves and goggles when you work with power tools to prevent injury.

• #1 Low Platelet Count (Thrombocytopenia) | OncoLink

  https://www.oncolink.org/support/side-effects/low-blood-counts/low-platelet-count-thrombocytopenia

  Other things you can do to prevent bleeding: Do not cough hard. If you have a cough, ask your provider if you can take cough medicine. Do not blow your nose too hard. Try to not push hard with bowel movements. If you are constipated, take a stool softener or laxative to make it easier. Do not use rectal thermometers, suppositories, or enemas. Use an electric razor for shaving. Do not have any dental work or cleaning before talking to your care team. Do not take any medications that affect blood clotting. […] Lifestyle changes to lessen the risk of bleeding: Avoid strenuous activity and lifting heavy objects. Avoid sports and activities that could result in falling and/or injury, like bike riding, rollerblading, skating, and skiing. Drink 8 to 10, 8-ounce glasses of non-alcoholic fluid a day to keep your mouth moist, to avoid constipation, and to keep the intestinal lining working well. Always wear shoes or slippers to protect your feet. Do not wear tight-fitting clothing. Talk to your care team about sexual activity. Talk to them about your sexual practices to see if they are safe.

• #1 Prophylactic platelet transfusions versus no prophylaxis in hospitalized patients with thrombocytopenia: A systematic review with meta‐analysis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9805167/

  The primary argument for the use of prophylactic platelet transfusions in patients with severe thrombocytopenia is to prevent bleeding. We found that prophylactic platelet transfusion may reduce the proportion of patients with at least one episode of clinically important bleeding. However, less than 15% of the RIS has been accrued, the TSA-adjusted CI was wide and included clinically relevant benefit and harm, and the overall certainty of evidence was very low. […] In conclusion, prophylactic platelet transfusion may reduce clinically important bleeding in hospitalized patients with hematological malignancy or dengue fever, but the evidence is very uncertain, and the generalizability to other patient populations is unclear. The effects on mortality and adverse events are uncertain and data from nonhematological settings are sparse. To move forward, RCTs are warranted to test the benefits and harms of platelet transfusion in diverse hospitalized populations with thrombocytopenia.

• #1 Testing and management of fetal and neonatal alloimmune thrombocytopenia | Professional Education

  https://professionaleducation.blood.ca/en/transfusion/best-practices/testing-and-management-fetal-and-neonatal-alloimmune-thrombocytopenia

  Although the evidence informing postnatal management of FNAIT is also limited, it is generally agreed that platelet transfusion should be provided without delay to a thrombocytopenic neonate. Prophylactic platelet transfusion is strongly recommended to keep the platelet count over 30 x 109/l. […] As a result of these studies, the recommendation provided by the ICTMG is to administer HPA matched platelets for prophylaxis and active bleeding in neonates with FNAIT if they are immediately available. If not immediately available, platelet transfusion should not be delayed and unmatched units should be given, either for the entire course of treatment, or until a matched product is available. […] There is interest in, and ongoing research on, developing a similar approach to prevent anti-HPA-1a development. A recombinant anti-HPA-1a antibody has been tested in humans and was found to successfully clear HPA-1a positive platelets.

• #1 Peri-Procedural Management of Bleeding Risk in Cirrhosis | AASLD

  https://www.aasld.org/liver-fellow-network/core-series/clinical-pearls/peri-procedural-management-bleeding-risk-cirrhosis

  C. Her thrombocytopenia and INR level do not need to be corrected to prevent post-liver biopsy bleeding. […] The American Association for the Study of Liver Disease (AASLD) abstain from a recommendation regarding routine preprocedural correction of thrombocytopenia before performing high risk of bleeding procedures due to lack of sufficient data. […] The Society for Interventional Radiology recommends a platelet count over 30 x 109/L as a safe threshold for performing high risk of bleeding procedures. […] The American Gastroenterological Association (AGA) and the American College of Gastroenterology (ACG) recommend a platelet count over 50 x 109/L as a safe threshold for performing high risk of bleeding procedures. […] At this point in time an individualized approach should be undertaken until definitive evidence is available.

• #1

  https://journals.lww.com/hepcomm/fulltext/2019/11000/thrombocytopenia_and_procedural_prophylaxis_in_the.3.aspx

  Thrombocytopenia is common in patients with advanced liver disease. These patients frequently require invasive diagnostic or therapeutic procedures in the setting of thrombocytopenia. A common platelet goal before such procedures is 50,000/L, but target levels vary by provider and the procedure. […] Avatrombopag and lusutrombopag can be used in certain patients with thrombocytopenia due to advanced liver disease undergoing elective invasive procedures; these new agents are highly effective in carefully selected patients, and real world data of safety and efficacy are awaited. […] The following review will discuss the current management strategies for periprocedural thrombocytopenia, including platelet transfusions and the role of TPO receptor agonists. […] TPO receptor agonists are indicated for stable nonbleeding patients with cirrhosis with severe thrombocytopenia undergoing planned elective procedures. For reasons noted above, TPO agonists are preferable to platelet transfusions if possible. […] We suggest that the patient’s health care provider determine whether TPO receptor agonists are appropriate for specific patients depending on the nature of the planned procedure, baseline platelet count, and the platelet goals of the provider performing the procedure.

• #1 Anticoagulation in individuals with thrombocytopenia – UpToDate

  https://www.uptodate.com/contents/anticoagulation-in-individuals-with-thrombocytopenia

  Thrombocytopenia may increase bleeding risk, but it does not protect against venous thromboembolism (VTE) or stroke. Thus, caring for patients with both thrombocytopenia and an indication for anticoagulation (eg, VTE prophylaxis or treatment, stroke prophylaxis or treatment) can be challenging. Evidence to guide appropriate therapy in this setting is very limited. […] This topic discusses our approach to the use of anticoagulation in an individual with thrombocytopenia, including decisions about the need for anticoagulation, anticoagulant dosing, therapies to raise the platelet count, and alternatives to anticoagulation if the bleeding risk is thought to be too high. […] Risk and prevention of VTE – (See „Risk and prevention of venous thromboembolism in adults with cancer”.)

• #1 When Should VTE Prophylaxis Be Initiated in Patients With Thrombocytopenia? – Hematology Advisor

  https://www.hematologyadvisor.com/news/when-should-vte-prophylaxis-be-initiated-in-patients-with-thrombocytopenia/

  A new study aims to address the conundrum of coagulation risk in patients hospitalized for hematologic malignancies. Researchers quantified the risks of bleeding and VTE associated with early VTE prophylaxis in critically ill patients with thrombocytopenia in a range of platelet counts. The probability for early initiation of VTE prophylaxis increased as platelet counts increased from 0 to 100 x 109/L and was stable at higher levels. […] Among critically ill patients with thrombocytopenia, use of venous thromboembolism (VTE) prophylaxis decreased in patients with a platelet count less than 100 x 109/L, and the risk of bleeding associated with VTE prophylaxis was the highest at a platelet count of less than 50 x 109/L, according to a research letter published in the Annals of the American Thoracic Society.

• #1 When Should VTE Prophylaxis Be Initiated in Patients With Thrombocytopenia? – Hematology Advisor

  https://www.hematologyadvisor.com/news/when-should-vte-prophylaxis-be-initiated-in-patients-with-thrombocytopenia/

  Little evidence exists to guide clinicians in decisions regarding VTE prophylaxis in patients with thrombocytopenia. […] These results can help inform the decision to initiate VTE prophylaxis in critically ill patients with thrombocytopenia. […] A significant interaction between platelet count and early VTE prophylaxis (P .001) was found in the model for RBC transfusion, with the effect estimate direction indicating that the RBC transfusion risk was greater when VTE prophylaxis was initiated at a lower platelet count. […] These results can help inform the decision to initiate VTE prophylaxis in critically ill patients with thrombocytopenia, the study authors commented.

• #1 Thieme E-Journals – Seminars in Thrombosis and Hemostasis / Abstract

  https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0031-1273090

  Current guidelines for venous thromboembolism (VTE) primary prophylaxis are based on randomized clinical trials that exclude subjects at a potentially high bleeding risk. Thus no specific recommendation/algorithm for pharmacological prophylaxis in patients with thrombocytopenia and/or platelet dysfunction is available. […] In severe thrombocytopenia, prophylaxis should be considered on an individual basis, however. […] VTE prophylaxis in high-risk conditions is thus suggested in these patients. […] Except in cases with contraindications to anticoagulation, antithrombotic prophylaxis should be always considered in hospitalized cancer patients with thrombocytopenia, especially in those with hematologic malignancies and multiple VTE risk factors. […] The need for VTE prophylaxis in patients on chronic treatment with aspirin and/or clopidogrel should be evaluated after assessing the individual risk-benefit ratio.

• #1 rhIL-11 for the Prevention of Dose-Limiting Chemotherapy-Induced Thrombocytopenia

  https://www.cancernetwork.com/view/rhil-11-prevention-dose-limiting-chemotherapy-induced-thrombocytopenia

  In order to derive maximum benefit from treatment with chemotherapeutic agents, adherence to the established chemotherapy dose and schedule is imperative. […] However, delivering the full amount of the calculated dose is not always possible because of the toxic effects on bone marrowparticularly hematologic toxicities such as neutropenia and thrombocytopeniainvariably caused by anticancer treatments. […] This approach presents the possibility of enabling cancer patients to receive full doses of chemotherapy without interruption, potentially improving tumor control and, ultimately, survival. […] Recombinant human interleukin-11 (rhIL-11, also known as oprelvekin [Neumega]) is currently the only drug approved by the US Food and Drug Administration for the prevention of chemotherapy-induced thrombocytopenia in patients with nonmyeloid malignancies.

• #1 rhIL-11 for the Prevention of Dose-Limiting Chemotherapy-Induced Thrombocytopenia

  https://www.cancernetwork.com/view/rhil-11-prevention-dose-limiting-chemotherapy-induced-thrombocytopenia

  Prophylactic therapy with rhIL-11 must be started within 24 hours after the last dose of chemotherapy and continued for 10 to 21 days until platelet counts of 50,000/L are achieved. […] For the purpose of supporting the delivery of unmodified chemotherapy regimens, rhIL-11 therapy should be initiated prophylactically, when there is a high probability that platelet reductions resulting in dose reduction and/or delay will occur (platelet counts of 50,000 or even 70,000/L). […] A demonstrated ancillary benefit of rhIL-11 therapys thrombopoietic effect is avoidance of platelet transfusions. […] In summary, when used appropriately, rhIL-11 enhances platelet recovery and, thus, facilitates the maintenance of aggressive chemotherapy regimens without dose modification, thereby enabling the best possible outcome in patients with nonmyeloid malignancies.

• #1 Thrombopoietin receptor agonists for prevention and treatment of chemotherapy-induced thrombocytopenia in patients with solid tumours | Cochrane

  https://www.cochrane.org/CD012035/HAEMATOL_thrombopoietin-receptor-agonists-prevention-and-treatment-chemotherapy-induced-thrombocytopenia

  Thrombopoietin receptor agonists (TPO-RAs) may be used to: (1) prevent CIT in patients with normal platelet count before chemotherapy, (2) prevent recurrence of CIT, and (3) treat CIT in patients with low platelet count during chemotherapy. […] To prevent CIT, the review shows that when patients (206 participants) with normal platelet count before chemotherapy are given eltrombopag (multiple-dose oral administration with chemotherapy), compared to placebo: […] To prevent recurrence of CIT, the review shows that when patients (62 participants) with low platelet counts during a chemotherapy cycle are given romiplostim (single-dose subcutaneous administration with chemotherapy), compared to placebo: […] There is low and very low quality evidence for the use of TPO-RAs to prevent CIT or prevent recurrence of CIT in patients with solid tumours. […] The available weak evidence did not support the use of TPO-RAs for preventing CIT or preventing recurrence of CIT in patients with solid tumours.

• #1 Low platelet count (thrombocytopenia) | Canadian Cancer Society

  https://cancer.ca/en/treatments/side-effects/low-platelet-count

  Thrombocytopenia is a condition caused by a low number of platelets in the blood. […] It may be difficult to prevent thrombocytopenia caused by cancer or chemotherapy. You can try the following to help prevent bleeding or bruising if your platelet counts are low. […] Do not take any over-the-counter medicines, such as pain relievers or cold remedies, without checking with the doctor first. These medicines may contain aspirin or other drugs that can weaken the platelets and make bleeding problems worse. […] The healthcare team may also give medicines to help the body make more platelets. These are called growth factors. Interleukin-11 is an example of a growth factor. Growth factors may help prevent severe thrombocytopenia.

• #1 What Is Immune Thrombocytopenia (ITP): Symptoms, Causes, Diagnosis, Treatment, and Prevention | Everyday Health

  https://www.everydayhealth.com/immune-thrombocytopenia/guide/

  There is no known way to prevent ITP, but there are steps you can take to prevent complications. […] These include avoiding medicines that can increase the risk of bleeding, such as ibuprofen (Advil) and aspirin. Always talk to your doctor before starting any new medication or supplement. […] Avoid contact sports that can lead to head injuries, such as boxing, football, and karate. Generally, swimming, cycling with a helmet, and walking are considered safe forms of physical activity. […] If you have any signs of an infection, especially a fever, call your doctor right away. Getting prompt treatment can help prevent complications.

• #1 Idiopathic Thrombocytopenic Purpura (ITP) | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/idiopathic-thrombocytopenic-purpura-itp

  Not all children with ITP require treatment. Close monitoring of your child’s platelets and prevention of serious bleeding complications may be the course of action chosen until the body is able to correct the disorder on its own. Many children with ITP are able to spontaneously recover in about 2 to 4 days. […] If your child has ITP, you’ll need to learn how to best prevent injuries and bleeding. Consider the following: […] For the young child, make the environment as safe as possible. Padding a crib, wearing helmets, and providing protective clothing are necessary when platelet counts are low. […] Contact sports, riding bicycles and rough play may need to be restricted. […] Avoid medications which contain aspirin, as they may interfere with the body’s ability to control bleeding.

• #1

  https://journals.lww.com/hemasphere/abstract/2019/06001/pb2250_is_antimicrobial_prophylaxis_required_in.2116.aspx

  Antimicrobial prophylaxis was not administered to any child. […] In our study, none of the ITP patients treated with RTX received antimicrobial prophylaxis, mainly because of their young age and absence of comorbidities.

• #1

  https://link.springer.com/article/10.1007/s00277-021-04438-7

  The primary aim of this study was to describe the use of primary anti-infective prophylaxis (AP) in common clinical practice in patients affected by immune thrombocytopenia (ITP) and treated with RTX. […] In conclusion, despite the absence of clear evidence, our analysis shows that AP in patients with ITP receiving RTX is frequently adopted, even if in the absence of well-defined criteria. Prophylaxis administration is quite consistent within the same haematological Center; thus, it seems related to clinicians experience.

• #1 Gestational Thrombocytopenia: Causes, Symptoms, Treatment

  https://www.healthline.com/health/pregnancy/gestational-thrombocytopenia

  Gestational thrombocytopenia (low platelet count) is common during pregnancy and usually doesnt cause complications. […] Its not always possible to prevent thrombocytopenia in pregnancy. With that said, there may be a link between low platelet counts and a lack of folic acid in the bloodstream, so its important that you take a prenatal vitamin with folic acid. […] In addition, infections can deplete your platelets. Its important to do your best to support your health by maintaining good hygiene, getting tested for sexually transmitted infections (STIs), and ensuring your vaccines are up to date.

• #1 Management of immune thrombocytopenia in pregnancy – Poston – Annals of Blood

  https://aob.amegroups.org/article/view/6305/html

  Immune thrombocytopenia (ITP) presents unique challenges in the peripartum setting. Management of ITP will change over the course of pregnancy and closer monitoring is critical as delivery approaches when the recommended platelet goal increases from 2010930109/L to above 50109/L for a vaginal delivery. If an epidural is required, the platelet count should be above 70109/L. First line therapies are glucocorticoids or intravenous immunoglobulin (IVIG). Many second line therapies may be safe in pregnancy. ITP is not a contraindication for pregnancy; women with a history of ITP should not be discouraged from becoming pregnant as their ITP can be safely managed with close monitoring and multidisciplinary coordination with obstetrics and pediatrics. The decision to start therapy is based on the degree of thrombocytopenia, signs of bleeding, and status of the pregnancy. During the first and second trimesters, platelet counts may be safely maintained at 2010930109/L. Higher platelet goals could be considered if there are signs of bleeding or a procedure is required. During the third trimester, the platelet count should be closely monitored. As the mother approaches delivery, platelet counts should be treated to maintain the platelet count above 50109/L with the least toxicity possible as the risk of bleeding during delivery increases when the platelet count is under 50109/L. First line therapies are similar to ITP in the non-pregnant patient. IVIG and glucocorticoids appear to have similar efficacy in peripartum ITP and have minimal risk to the fetus. The risk of antifibrinolytic therapies during pregnancy is unknown although it is safe and effective for postpartum bleeding. Additionally, the impact on maternal and fetal outcomes must be considered when selecting second line therapies. Contraindicated ITP directed therapies due to adverse fetal outcomes include: syk inhibitors, vinca alkaloids, mycophenolate mofetil, cyclophosphamide and danazol. ITP can worsen after delivery, especially in women with a history of a splenectomy, and all should be closely monitored for postpartum hemorrhage. Women with ITP remain at risk for venous thrombosis and prophylaxis should be used as indicated in routine pregnancy.

• #1 Thrombocytopenia: Symptoms, Stages & Treatment

  https://my.clevelandclinic.org/health/diseases/14430-thrombocytopenia

  The most important thing is to understand if you have medical conditions or take medication that increases your risk of developing thrombocytopenia. If you do, ask your healthcare provider if there are medications or activities you should avoid. […] Thrombocytopenia low platelet levels may increase your risk of issues like excessive bleeding and bruising. Severe thrombocytopenia increases your risk of internal bleeding or heart attack. If you have this condition, its important to understand why you have low platelet levels. Your healthcare provider can explain whats causing the low platelet count and discuss treatment options. Theyll also discuss lifestyle changes that may boost your platelet levels.

• #1 Unveiling the Power of Functional Medicine and Advanced Lab Testing for Effective Prevention and Treatment of Thrombocytopenia

  https://www.rupahealth.com/post/unveiling-the-power-of-integrative-medicine-and-advanced-lab-testing-for-effective-prevention-and-treatment-of-thrombocytopenia

  The goal of managing thrombocytopenia is to support an increase in your platelet count to help reduce your risk of bleeding, both internally and externally. […] An integrative approach that combines conventional medicine with a more holistic view incorporating nutrition, lifestyle, and complementary therapies can be effective. […] An integrative medicine approach develops an individualized plan to help support normal platelet levels using diet and nutrition, supplementation, and lifestyle changes. Early and regular monitoring with functional medicine laboratory testing helps to provide recognition of issues to take a proactive approach. It also allows for targeted management that addresses body imbalances and root causes of thrombocytopenia.

• #1

  https://www.jci.org/articles/view/118099

  Effective prevention of thrombocytopenia in mice using adenovirus-mediated transfer of HST-1 (FGF-4) gene. […] To investigate whether Adex1HST-1 could effectively prevent experimentally induced thrombocytopenia in mice, we injected Adex1HST-1 intraperitoneally into thrombocytopenic mice induced by administration of a chemotherapeutic agent and/or by irradiation. […] Therefore, this method could be useful for treatment and/or prevention of thrombocytopenia induced by chemotherapy and/or irradiation for cancer treatment.

• #1 Prevention of thrombocytopenia and thrombosis in heparin-induced thrombocytopenia (HIT) using deglycosylated KKO: A novel therapeutic? | bioRxiv

  https://www.biorxiv.org/content/10.1101/2022.10.19.512755v1

  Heparin-induced thrombocytopenia (HIT) is characterized by mild thrombocytopenia associated with a highly prothrombotic state due to the development of pathogenic antibodies that recognize human (h) platelet factor 4 (PF4) complexed with various polyanions. […] We now asked whether Fc-modified KKO can be used as a novel therapeutic to prevent or treat HIT. […] DGKKO can prevent/reverse thrombosis in vitro and in a HIT murine model. […] DGKKO may represent a new class of therapeutics for targeted treatment of patients with HIT.

• #2 Thrombocytopenia: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000586.htm

  Prevention depends on the specific cause.

• #2 Low Platelet Count (Thrombocytopenia)

  https://www.healthline.com/health/thrombocytopenia

  If you are at risk of developing a low platelet count, scheduling regular doctors visits will help you pay attention to potential signs and symptoms. […] If you are at risk of developing a low platelet count due to an underlying condition or medical history, your healthcare professional may recommend that you take prevention measures. These may include: […] avoiding activities with a high risk of bleeding or bruising (i.e., contact sports) […] limiting alcohol consumption […] making dietary changes […] stopping or switching medications that affect platelets, including aspirin and ibuprofen […] getting certain types of vaccinations […] avoiding toxic chemicals.

• #2 Treatment and Prevention of Thrombocytopenia

  https://www.medindia.net/health/conditions/treatment-and-prevention-of-thrombocytopenia.htm

  In the event that thrombocytopenia is caused by a side effect of medications, stopping the medications will cause the platelet levels to return to normal. […] Individuals with thrombocytopenia should avoid drinking alcohol. […] Platelet production is reduced when alcohol is consumed. […] Over-the counter medications such as aspirin and ibuprofen can reduce platelet production. […] Caution is advised on the use of such medications. […] Individuals with thrombocytopenia should avoid injury-prone activities such as football, boxing, hockey, among others. […] Individuals should wear protective gloves while using knives, and wear seatbelts when riding a vehicle. […] Certain viruses affect platelet levels. […] Individuals affected with thrombocytopenia should get vaccinated for these viruses.

• #2 Treatment and Prevention of Thrombocytopenia

  https://www.medindia.net/health/conditions/treatment-and-prevention-of-thrombocytopenia.htm

  Individuals with thrombocytopenia should avoid contact with chemicals such as benzene, pesticides, and arsenic. […] Such chemicals affect the production of platelets. […] If an individual has undergone splenectomy, he/she is prone to infections due to a compromised immune system. […] Hence, the individual should inform a doctor immediately if there is an indication of an infection.

• #2 Thrombocytopenia Guide: Causes, Symptoms and Treatment Options

  https://www.drugs.com/health-guide/thrombocytopenia.html

  Many cases of thrombocytopenia cannot be prevented. You can avoid drinking large amounts of alcohol to lower your risk of developing alcohol-related thrombocytopenia. […] If you already have had one episode of drug-induced thrombocytopenia, the problem is likely to return if you take the same medication again. To help prevent this, record the name of the specific medication that caused the problem. Tell every health care professional that you visit about your sensitivity to this drug. […] If your doctor has determined that you are at risk of developing this condition, he or she may tell you not to take aspirin or other anti-inflammatory drugs such as ibuprofen. That is because these medicines impair platelet function.

• #2 Thrombocytopenia (Low Platelet Count): Definition, Causes, Symptoms, and Treatment

  https://www.webmd.com/a-to-z-guides/thrombocytopenia-causes-treatment

  If your platelet count isn’t too low, you might not need treatment. […] To prevent bleeding when your platelet count is low: Don’t take medicines that can affect how well your platelets work, like aspirin and ibuprofen. […] Limit how much alcohol you drink, because it can make bleeding worse. […] Don’t take part in contact sports, like football or boxing, in which you might get injured. […] Use a soft toothbrush to protect your gums. […] Wear a seatbelt when you’re in a car, and put on gloves and goggles when you work with power tools to prevent injury.

• #2 Thrombocytopenia | Blood Disorders

  https://health.ucdavis.edu/conditions/thrombocytopenia

  Its not possible to prevent all thrombocytopenia causes. But some are within your control. […] Take extra precautions to avoid infections, like washing your hands and disinfecting high-touch surfaces. […] Vitamin B12 and folate help your bone marrow produce platelets. You can find these nutrients in leafy greens, beans and lean proteins like fish. […] If you need medications, talk to your provider about the safest options. Certain antibiotics, blood thinners and anti-inflammatories can affect platelet count.

• #2 Low Platelet Count (Thrombocytopenia) | OncoLink

  https://www.oncolink.org/support/side-effects/low-blood-counts/low-platelet-count-thrombocytopenia

  Thrombocytopenia puts you at a higher risk of bleeding. If you have a low platelet count, you should avoid any activities that could lead to bleeding. […] While getting certain treatments, there is nothing that you can do to prevent thrombocytopenia. […] What can I do to prevent bleeding if I have thrombocytopenia? Keep your mouth clean and moist. Brush your teeth gently with a soft bristle toothbrush. If you cannot use a toothbrush, use a sponge toothette to clean your teeth and gums. Rinse your mouth after each meal with a baking soda solution (2 tsp. baking soda to every 8 oz. water). Do not use dental floss. Do not use mouthwashes that have alcohol in them. Alcohol can dry out your mouth, which may lead to bleeding. Use petroleum jelly or other lip balms to keep your lips moist and to prevent cracking. Take sips of water or juice often if your tongue or mouth feels dry. Modify feminine hygiene practices: Use sanitary napkins rather than tampons during menstruation. Avoid vaginal douching.

• #2 Low Platelet Count (Thrombocytopenia) | OncoLink

  https://www.oncolink.org/support/side-effects/low-blood-counts/low-platelet-count-thrombocytopenia

  Other things you can do to prevent bleeding: Do not cough hard. If you have a cough, ask your provider if you can take cough medicine. Do not blow your nose too hard. Try to not push hard with bowel movements. If you are constipated, take a stool softener or laxative to make it easier. Do not use rectal thermometers, suppositories, or enemas. Use an electric razor for shaving. Do not have any dental work or cleaning before talking to your care team. Do not take any medications that affect blood clotting. […] Lifestyle changes to lessen the risk of bleeding: Avoid strenuous activity and lifting heavy objects. Avoid sports and activities that could result in falling and/or injury, like bike riding, rollerblading, skating, and skiing. Drink 8 to 10, 8-ounce glasses of non-alcoholic fluid a day to keep your mouth moist, to avoid constipation, and to keep the intestinal lining working well. Always wear shoes or slippers to protect your feet. Do not wear tight-fitting clothing. Talk to your care team about sexual activity. Talk to them about your sexual practices to see if they are safe.

• #2 Prophylactic platelet transfusions versus no prophylaxis in hospitalized patients with thrombocytopenia: A systematic review with meta‐analysis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9805167/

  Thrombocytopenia is a common condition in several populations of hospitalized patients, including those with hematological and solid tumor cancer, those with chronic liver disease, and critically ill neonates and adults, and it has been associated with increased rates of bleeding, transfusion requirements, and mortality. Prophylactic platelet transfusions are often recommended in patients with severe thrombocytopenia, but the supporting evidence is primarily derived from trials in hematological patients and clinical practice varies considerably. Prior to prophylactic platelet transfusion, the risk of bleeding and the beneficial effects of transfusion must be viewed in light of the potentially harmful effects, which, although rare, include serious and potentially life-threatening reactions, such as anaphylaxis, transfusion-transmitted infections, and transfusion-related acute lung injury. Therefore, we aimed to assess the benefits and harms of prophylactic platelet transfusions versus no prophylaxis on patient-important outcomes in hospitalized patients with thrombocytopenia. We hypothesized that the evidence base for nonhematological patients would be sparse and uncertain.

• #2 Anticoagulation in individuals with thrombocytopenia – UpToDate

  https://www.uptodate.com/contents/anticoagulation-in-individuals-with-thrombocytopenia/print

  Thrombocytopenia may increase bleeding risk, but it does not protect against venous thromboembolism (VTE) or stroke. Thus, caring for patients with both thrombocytopenia and an indication for anticoagulation (eg, VTE prophylaxis or treatment, stroke prophylaxis or treatment) can be challenging. Evidence to guide appropriate therapy in this setting is very limited. […] This topic discusses our approach to the use of anticoagulation in an individual with thrombocytopenia, including decisions about the need for anticoagulation, anticoagulant dosing, therapies to raise the platelet count, and alternatives to anticoagulation if the bleeding risk is thought to be too high.

• #2 When Should VTE Prophylaxis Be Initiated in Patients With Thrombocytopenia? – Pulmonology Advisor

  https://www.pulmonologyadvisor.com/news/when-should-vte-prophylaxis-be-initiated-in-patients-with-thrombocytopenia/

  The probability for early initiation of VTE prophylaxis increased as platelet counts increased from 0 to 100 x 109/L and was stable at higher levels. […] Among critically ill patients with thrombocytopenia, use of venous thromboembolism (VTE) prophylaxis decreased in patients with a platelet count less than 100 x 109/L, and the risk of bleeding associated with VTE prophylaxis was the highest at a platelet count of less than 50 x 109/L, according to a research letter published in the Annals of the American Thoracic Society. […] These results can help inform the decision to initiate VTE prophylaxis in critically ill patients with thrombocytopenia. […] A significant interaction between platelet count and early VTE prophylaxis (P .001) was found in the model for RBC transfusion, with the effect estimate direction indicating that the RBC transfusion risk was greater when VTE prophylaxis was initiated at a lower platelet count. […] These results can help inform the decision to initiate VTE prophylaxis in critically ill patients with thrombocytopenia, the study authors commented.

• #2 Thrombopoietin receptor agonists for prevention and treatment of chemotherapy-induced thrombocytopenia in patients with solid tumours | Cochrane

  https://www.cochrane.org/CD012035/HAEMATOL_thrombopoietin-receptor-agonists-prevention-and-treatment-chemotherapy-induced-thrombocytopenia

  Thrombopoietin receptor agonists (TPO-RAs) may be used to: (1) prevent CIT in patients with normal platelet count before chemotherapy, (2) prevent recurrence of CIT, and (3) treat CIT in patients with low platelet count during chemotherapy. […] To prevent CIT, the review shows that when patients (206 participants) with normal platelet count before chemotherapy are given eltrombopag (multiple-dose oral administration with chemotherapy), compared to placebo: […] To prevent recurrence of CIT, the review shows that when patients (62 participants) with low platelet counts during a chemotherapy cycle are given romiplostim (single-dose subcutaneous administration with chemotherapy), compared to placebo: […] There is low and very low quality evidence for the use of TPO-RAs to prevent CIT or prevent recurrence of CIT in patients with solid tumours. […] The available weak evidence did not support the use of TPO-RAs for preventing CIT or preventing recurrence of CIT in patients with solid tumours.

• #2 What Is Immune Thrombocytopenia (ITP): Symptoms, Causes, Diagnosis, Treatment, and Prevention | Everyday Health

  https://www.everydayhealth.com/immune-thrombocytopenia/guide/

  There is no known way to prevent ITP, but there are steps you can take to prevent complications. […] These include avoiding medicines that can increase the risk of bleeding, such as ibuprofen (Advil) and aspirin. Always talk to your doctor before starting any new medication or supplement. […] Avoid contact sports that can lead to head injuries, such as boxing, football, and karate. Generally, swimming, cycling with a helmet, and walking are considered safe forms of physical activity. […] If you have any signs of an infection, especially a fever, call your doctor right away. Getting prompt treatment can help prevent complications.

• #2

  https://link.springer.com/article/10.1007/s00277-021-04438-7

  The primary aim of this study was to describe the use of primary anti-infective prophylaxis (AP) in common clinical practice in patients affected by immune thrombocytopenia (ITP) and treated with RTX. […] In conclusion, despite the absence of clear evidence, our analysis shows that AP in patients with ITP receiving RTX is frequently adopted, even if in the absence of well-defined criteria. Prophylaxis administration is quite consistent within the same haematological Center; thus, it seems related to clinicians experience.

• #2 Thieme E-Journals – Seminars in Thrombosis and Hemostasis / Abstract

  https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0031-1273090

  Current guidelines for venous thromboembolism (VTE) primary prophylaxis are based on randomized clinical trials that exclude subjects at a potentially high bleeding risk. Thus no specific recommendation/algorithm for pharmacological prophylaxis in patients with thrombocytopenia and/or platelet dysfunction is available. […] In severe thrombocytopenia, prophylaxis should be considered on an individual basis, however. […] VTE prophylaxis in high-risk conditions is thus suggested in these patients. […] Except in cases with contraindications to anticoagulation, antithrombotic prophylaxis should be always considered in hospitalized cancer patients with thrombocytopenia, especially in those with hematologic malignancies and multiple VTE risk factors. […] The need for VTE prophylaxis in patients on chronic treatment with aspirin and/or clopidogrel should be evaluated after assessing the individual risk-benefit ratio.

• #2 Prevention of thrombocytopenia and thrombosis in heparin-induced thrombocytopenia (HIT) using deglycosylated KKO: A novel therapeutic? | bioRxiv

  https://www.biorxiv.org/content/10.1101/2022.10.19.512755v1

  Heparin-induced thrombocytopenia (HIT) is characterized by mild thrombocytopenia associated with a highly prothrombotic state due to the development of pathogenic antibodies that recognize human (h) platelet factor 4 (PF4) complexed with various polyanions. […] We now asked whether Fc-modified KKO can be used as a novel therapeutic to prevent or treat HIT. […] DGKKO can prevent/reverse thrombosis in vitro and in a HIT murine model. […] DGKKO may represent a new class of therapeutics for targeted treatment of patients with HIT.

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