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This question was answered on Mon 14, Jul 2008 10:02pm by Dr Paul S, MD

Chemotherapy cycle 6 is delayed - blood platelet count is too low!


    
Asked by phill86519 (Female; 64; Duke's Stage C Colon Cancer, Colon resection - 4/21 lymph nodes impacted, PET Scan shows no metastasis, liver has hemangiomas; Relevant drugs:Adjuvant chemotherapy of FOLFOX-4 ) on Sat 12, Jul 2008 08:41am

Dear Doctor, My mother is undergoing chemotherapy for colon cancer and her response to the first four cycles was great - in fact her blood counts except platelets were improving with chemotherapy. However, after the fifth cycle, her platelet count has plummeted and doctors have refused to administer chemotherapy until they go back up to over 100,000 Her platelet count the day before the scheduled chemotherapy was 80,000 (it has been on the low end of normal and reducing each time). After four days of delay, the platelets have further reduced to 60,000. Currently, her sixth cycle of chemotherapy is already at least one week delayed. She has been eating healthy with a very high protein diet and increase in vitamin B12 as well trying to exercise. Is there anything that she can do to improve her platelet count - the doctors has reluctant to do a transfusion or try Neumega for fear of side-effects. Kindly advise - we will look forward to any advice on diet, etc. to improve her platelet count. Thank you so much!
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Answer by Dr Paul S, MD  on Mon 14, Jul 2008 10:02pm:

Hi. Decreasing platelet count (thrombocytopenia), is a natural consequence of chemotherapy for colon cancer, especially towards the last few cycles. There are really not much proven ways to increase the platelet count aside from platelet transfusion or using drugs like oprelvekin (Neumega) to quickly increase the platelet count. Platelet transfusion would cause an immediate rise of platelet counts while oprelvekin would still take about a few days to a week. These indeed have side effects, but with a specialized center, I believe that the side effects can be managed very well (allergic reactions, flu-like symptoms, etc.), and that the chemotherapy can be given as close to the usual schedule as possible. Also, there are no proven diets to increase the platelets, but some would advocate eating green leafy vegetables to aid in the recovery of blood components. I suggest you still discuss with her doctors regarding transfusion and oprelvekin, and come up with a decision that is amenable to both. Regards.

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