Question:

My mom got diagnosed in March 09 with ALL. Underwent treatments and her platelets are 40 now. She has been off chemo for 5 weeks now but since middle of March has got some kind of chemo everyday. What would cause her platelets not to be higher than they are? What is a normal reading number for leukemia patients the platelet number?

Answer:

ALL is a bone marrow cancer that requires treatment for a long time as long as the patient is responding. The average is 2 years. While taking chemotherapy most patients experience a reduction in red blood cells, white blood cells and platelets (pancytopenia) and may be even transfusion dependent for both blood and platelets.

After completing therapy and depending on the age and the marrow reserve, since platelets and blood are made in the marrow, we usually look for an average of three months to recovery. If recovery is delayed we then recommend performing a bone marrow exam to make sure the ALL is not back or even that the chemotherapy itself did not leave permanent effects on the marrow, what we call myelodysplastic syndrome which is especially more common to occur in the elderly patients. Also we would check vitamin B12 and folate levels which are necessary for marrow function and role out the possibility of any other drugs contributing to the prolonged marrow dysfunction.

There is really no normal platelet count for leukemia patients. When the platelets are above 20 thousands they are safe to prevent bleeding with regular activities. But again a delay of recovery to normal counts (above 100 thousands) should be investigated further. Hope it is helpful.

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