Platlets

[Annma]

Hiya just recovering from gall bladder infection which was quite severe been on two lots of antibiotics still got a couple of days left my platlets are usually around 600 hundred marker they are 1000 from yesterday blood test I take one hydroxycarbamide one day and two the next is this normall for platlets to rise so much. With infection my infection markers were high just bit worried Thank-you.

[Cja1956]

The.short answer is that platelets do tend to go up when you have other infections or illnesses to deal with. Also, you should be taking probiotics every day to offset some of the effects of the antibiotics.

[hunter5582]

Reactive thrombocytosis is a normal response to infection, injury, or bleeding events. Your platelet levels should return to baseline when your infection is resolved. You may find that you are bit more prone to bleeding/bruising with your PLT near 1,000 but there is no linear increase in risk of thrombosis. Best to consult with your MPN care team about the increase so they are aware and can give the best case-specific advice.

[Annma in reply to hunter5582]

Thank-you all my other blood work is within normall range just platlets went Up with infection

[johnnyjumpups in reply to hunter5582]

When you say that there is no linear increase in risk of thrombosis when our platelet levels rise ( I have seen this elsewhere and I know you are correct) can you tell me why our doctors are so intent on lowering platelet counts? Why take HU? I appreciate your response!

[RoundTheWorld in reply to johnnyjumpups]

I’m interested in others’ answers to this too. My understanding (happy to be corrected!) is:

- platelets play a part in thrombosis risk but it’s not linear and not yet fully understood

- part of the thrombosis risk is not from the number of platelets per se but how they behave (how ‘sticky’ they are)

- substantially raised platelets raise risk of haemorrhage

- reducing platelets may reduce some symptoms

- raised red blood cell (and so also haematocrit) count and white cell count play a part (and are probably more significant than platelets wrt thrombosis risk??)

[johnnyjumpups in reply to RoundTheWorld]

Thank you RoundTheWorld!

[hunter5582 in reply to johnnyjumpups]

There is disagreement in the MPN care world on the issue of a platelet target in treating ET. Some will try to make PLT "normal" even though there is no evidence to support this treatment target. Some will use 600 when a hard number is used. There is emerging thinking that it may be the delta (degree of change) that matters most.

The bottom line is that the risk of thrombosis is more about how the platelets behave than how many of them there are. HU does tend to make the blood more "slippery" in addition to reducing blood cell numbers. It is worth noting that there is a linear increase in risk of hemorrhage when platelet numbers are higher. This can be a significant concern for some.

Setting treatment goals is ideally individualized to the needs of each individual. We have different needs and different responses to treatment. Someone age 52 with the a CALR mutation and no history of thrombosis has a different treatment need than someone age 62 with JAK2 and a history of DVT.

Note that cytoreduction is clearly indicated in some cases. The choice of how to treat when cytoreduction is indicated is also individualized. HU is only one of the choices. Each individual needs to evaluate their options and determine which option best meets their treatment goals, risk tolerance, and treatment preferences.

Wishing you all the best.

[johnnyjumpups in reply to hunter5582]

Thank you Hunter5582!

[Frances1903]

So hope your doctor can advise you, as you note the platelets are rather high and responding to the effects of infection. Please do check in again once you are able to ask the opinion of your team/doctor.

[Annma in reply to Frances1903]

I got my appointment tomorrow Thank-you

[Plavers]

really sympathise Gall Bladder infections are incredibly painful after about 4 incidents I had mine removed and am not regretting it! I have ET Jak 2 am now 74. It was during this time I discovered the wonder of IV Paracetamol and how it could control the pain so effectively up against the opioid alternatives. Hopefully your medical team will look out for flare ups in the future.