Quote:
Originally Posted by Birgitta-A
Hi Margarete,
You know it is not only the platelet count that is important but the platelet function too. In MDS the platelets can be dysfunctional (mine are dysfunctional) so to assess the bleeding risk there is a test called PFA 100 (Platelet Function Analyzer).
http://www.medcorp.com.br/medcorp/up...9105163930.pdf
As you understand it is difficult to know when there is a risk for bleeding if you only measure the platelet count but most clinics don't give platelet transfusions if the patient has a platelet count of 20 or more. If the patients has severe bleedings from nose, mouth, rectum and so on they often give platelet transfusions even if the platelets count is higher.
Kind regards
Birgitta-A |
Thank you, dear Birgitta,for the informations, which gave me the opportunity of ongoing study this sunday.
As i understood from the Platelet Function Analyser, there is a difference in the platelet function whether the patient has "Destructive" or "Underproduction" Thrombocytopenia. For MDS patients this could mean,that thrombocytopenia with immune problems has on the other side advantages in regard to platelet functioning. I think i could also read today that these patients usually do not have dysplastic thrombocytes. "Underproduction" Thrombocytopenia in MDS has often platelet dysplasias and their platelet functioning is often decreased.
There exists a (one or more?) platelet consensus report from 1998. The conference leading to this report did not consider the läter happening expansion in the development of platelet function awareness. In a new consensus conference this will surely to be included in the discussions.
Also i could read today in a study that 20 % of the MDS-Patients with Thrombocytopenia died when this problem was combined with others, and 10 % solely because of the Thrombocytopenia. It should not be common to think that these deads happen because of the natural course of the disease, but instead it should be investigated in the very special case, why this dead occured and how this could have been prevented. In some cases the person probably did not reach the transplantation unit in time, or even he/she was not given the transplantation because of too high platelet values (but with bad functioning)...
Maybe it could help in some cases to have a sort of diary, where the patients writes down all the special problems with thrombocytopenia, bleedings, the blood counts, a list of current medicaments and treating docters.. And then show this in case of difficulties with the transfusions...
..
Kind regards
Margarete