Depressed platelet counts

Observational studies Therapy-related adverse events to moxetumomab pasudotox were assessed in a phase I trial in 28 patients with relapsed/refractory hairy cell leukaemia. Three patients experienced serious adverse reactions two showed depressed platelet counts and the third hypoxia and bronchospasm. The most common adverse events were grade 1 to 2 hypoalbuminaemia and elevated aminotransferases. Other less often seen events included headache, hypotension, nausea, fatigue, weight gain and myalgia [173 ]. 

Other adverse reactions associated with penicillin are hematopoietic changes such as anemia, thrombocytopenia (low platelet count), leukopenia (low white blood cell count), and bone marrow depression. When penicillin is given orally, glossitis (inflammation of the tongue), stomatitis (inflammation of die mouth), dry mouth, gastritis, nausea, vomiting, and abdominal pain occur. When penicillin is given intramuscularly (IM), there may be pain at die injection site Irritation of the vein and phlebitis (inflammation of a vein) may occur witii intravenous (IV) administration. 

Biood dyscrasias Agranulocytosis, bone marrow depression, neutropenia, hypoplastic anemia and thrombocytopenia in patients receiving procainamide have been reported at a rate of approximately 0.5%. Fatalities have occurred (with approximately 20% to 25% mortality in reported cases of agranulocytosis). Perform complete blood counts including white cell, differential, and platelet counts at weekly intervals for the first 3 months of therapy, and periodically thereafter. Perform complete blood counts promptly if the patient develops any signs of infection (eg. 

A 47-year-old woman who had had bilateral mastectomies for breast cancer became depressed and was given paroxetine 20 mg/day. After 15 days she developed widespread multiple ecchymoses over the arms, legs, and abdomen. Her platelet count, prothrombin time, partial thromboplastin time, and bleeding time were normal. Paroxetine was withdrawn, and 5 days later, the bruising had markedly abated and no new... 

A 31-year-old white man with depression, hepatitis C, and cirrhosis of the liver was hospitalized for alcohol detoxification. He had taken methadone 50 mg bd for opium dependence for 6 months. He developed bilateral pedal edema and 27 kg weight gain. There was no ascites, portal hypertension, or congestive heart failure. Most of his laboratory tests were within the reference ranges, except for reduced prothrombin time and platelet count. After stopping alcohol, his methadone dose was reduced to 60 mg/day his edema resolved 15 days later. When the dose of methadone was increased to 70 mg/day there was a progressive increase in the edema. When methadone was withdrawn his edema completely resolved and he lost 8 kg in 2 weeks. 

Moderate depression Decrease dose by 50%. If condition remains stable, continue reduced dosage. If symptoms improve and are stable for > 4 weeks, continue reduced dosage regimen or return to normal dose Severe depression Discontinue PEG-interferon a-2b permanently White blood cell count neutrophil count <750/mm or platelet count <80,000/mm Decrease dose by 50%... 

Fibrinogen levels and platelet counts are usually decreased in patients with DlC. Fifty percent of patients have schistocytes (red blood cell fragments) in fulminant DIC. Unfortunately, these findings may also be evident in patients with severe liver disease with hypersplenism. Depressed antithrombin, protein C, and protein S levels are seen in most patients. Severe initial decreases in antithrombin... 

Factor Vlll and V levels should be decreased in DlC, but results of these tests may be quite variable because of the systemic activation of the coagulation system. The most specific findings of DlC are a low platelet count associated with an elevated D-dimer level, fibrinopeptide A, and prothrombin 1 and 2, along with depressed antithrombin and fibrinogen levels. 

Bone marrow depression may occur when taking Imuran. The chent must have a CBC and platelet counts every week the first month of therapy, then biweekly for 2-3 months, and monthly thereafter. 

Aplastic anemia and agranulocytosis have been reported. Complete hematological testing should be obtained pretreatment. If a patient during the course of treatment exhibits low or decreased white blood cell or platelet counts, the patient should be monitored closely. Discontinuation of carbamazepine should be considered if any evidence of significant bone marrow depression develops. 

Hematologic/Lymphatic Anemia hemolytic anemia thrombocytopenia thrombocytopenic purpura eosinophilia leukopenia granulocytopenia neutropenia bone marrow depression agranulocytosis reduction of hemoglobin or hematocrit prolongation of bleeding and prothrombin time decrease in WBC and lymphocyte counts increase in lymphocytes, monocytes, basophils, and platelets. Hypersensitivity Adverse reactions (estimated incidence, 1% to 10%) are more likely to occur in individuals with previously demonstrated hypersensitivity. In penicillin-sensitive individuals with a history of allergy, asthma, or hay fever, the reactions may be immediate and severe. 

Radiophosphorus ( P, sodium radiophosphate) is given i.v. Phosphorus is concentrated in bone and in cells that are dividing rapidly, so that the erythrocyte precursors in the bone marrow receive most of the P-irradiation. The effects are similar to those of whole-body irradiation, and in PRV, P is a treatment option for those > 65 years (acaunulation in the gonads precludes its use in younger patients). The maximum effect on the blood count is delayed 1-2 months after a single dose that usually provides control for 1-2 years. It reduces vascular events and delays progression to myelofibrosis. Excessive depression of the bone marrow including leucocytes and platelets is the main adverse effect, but is seldom serious. Acute myeloid leukaemia occurs more frequently in patients treated with P especially when used in combination with hydroxyurea. 

Bone marrow depression due to damage to the growing stem cells causes reduction in the blood white cell, platelet, and red cell counts. These, in turn, could cause susceptibility to infections, excessive bleeding, and anemia. In addition, certain drugs cause unique and serious bone damage, such as the osteonecrosis of the jaw associated with bisphosphonates [88]. 

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