Inaccurate Platelet Results
 

Hi
I would really appreciate some help and advice.

My 72 year old father has been diagnosed with Aplastic Anaemia in July of this year. He has low red, white and platelets.

He attends the hospital twice a week for platelet transfusions and a week to 10 days for red blood transfusions.

He has been put on Cylosporine and has been on this for the last 8 weeks (with no improvement at present - but I am aware it is early days)

His platelet count never normally rises above 15-20 - but on odd occasions over the last few weeks they have been telling him his platelets are 35 or sometimes 50, sending him home, only then the following day him having to rush back to the hospital due to bleeding - and when retaking the platelets they can be 2 or 4!

I find it incredulous that there can be such an error in the blood results. Apparently it is very difficult to count low platelets for the purpose of blood results, but when they are sending him home with a reading of 50 and the following day it is 4 due to a mistake again, I feel it is putting his, already weakening body under more and more stress.

I just wondered if this was something that does happen regularly to those patients with low platelets - that the readings basically cannot be trusted, and if this is the case, how to you manage - do you insist on re-checks?

I know many of you are well aware of the stresses and strains surrounding these conditions, and I just want to be able to help advise my dad.

This week has been the worst of all - he was told 50 on Monday, and even though he told them he couldn't believe that was correct, he was sent home - only for me to find red blood blisters on his face yesterday, and a seeping blister behind his ear which was discharging on his neck. Blood all over his pillow today, and after being rushed back to the hospital - the reading today was 4.

Sorry for the waffle - I'm just completely frustrated and would appreciate any honest advice

Many thanks

Claire

Transfused platelet don't last very long to begin with. And yes, you can burn through those platelets very quickly. I'm not sure about the timing of the CBCs and transfusions from your post. Let's say he was transfused on Monday and checked again on Wednesday and was OK, then by Thursday he could be low again.

If they are doing a post-transfusion platelet count, it will usually be high. But if the body doesn't like those platelets, he could be back to 2 or 4 again by the next day or sooner. After a while, the body may become refractory to some or all platelet products.

You may want to have his clotting time checked if he's bleeding at 15 -20 K. Just to make sure he has enough clotting factors. You do need more than platelets for blood to clot. But platelets of 2 -4 K are pretty risky. John never had serious bleeds at 4K.

We found platelet counts to be pretty accurate. There were alway differences between the hospital and our doctor's office but they were never far off. If there are too few for the machine to count, they will count them manually. We also found that John's own 8K platelets worked much better than the 20-30K transfused platelets.

For me after the first few platelet transfusions that the platelets would be depleated very rapidly. To have 30 plateletes one day and 4 the next is not uncommon. I was given Amicar to help with clotting. It is a unpleasant tasting medicine but it helps with the bleeding. It took me 5 months to start responding after ATG and cyclosporine treatment. I now have 58 platelets where for months I had 7-8. I fould that unless I was actively bleeding avoiding the transfusions was a good thing. Ask about Amicar.

Scott