Too High Platelet count following Rituximab and Romiplostim

My wife has had a very low platelet count (between 0-5) for a few months. She was put on Romiplostim injections but they did not have any effect. She was then given a round of Rituximab and following this her platelet count increased to over 200. The Romiplostim injections were halted. Her platelet count has now increased to over 1600. Has anyone else had issued with extremely high platelet count following a very low platelet count.

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  • Hi kyriak51 here. Are you saying that you revived Rituxan and Nplate at the same time? Platelet count of 200, do you mean 200 thousand? Was that 200 a machine or manual count? I received Rituxan infusion weekly times 4 with no response, my counts remained between 5-10 thousand and required weekly platelet transfusions. I started Nplate the following week at 1mcg/kg with slow response and am currently on 8mcg/kg to maintain counts of 50-80 thousand. I have been receiving weekly injections since 2010, my highest count was 100-104 thousands three times since 2010. I have never heard of a count of 1600. How old are you, do you have immune ITP, do you have other medical conditions? Kyriak51:)

  • Welcome to NPlate extreme count club! I once maxed out at 1100 and one of the other members here (NickyD) went even higher but 1600 is the highest I have come across. How is you wife feeling at that count? I didn't really feel any different at 1100 than I did at 0 (apart from the medication side-effects and some symptoms). My specialist didn't panic when this happened but did instruct me to take a 1/4 tablet of aspirin at the time to make the platelets 'less sticky' and without taking any more NPlate I dropped back down to 300 the next week.

    Do you know what amount of NPlate she was given (in mcg/kg) and what her count was when she was given it?

    Hopefully she is OK and her count settles back down again quickly.

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