Platelet Disorders Treatment

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You may not need treatment if your platelet count reaches or stays in a healthy range. Some platelet disorders can get better on their own.

If you need treatment, your treatment plan will depend on the type of platelet disorder you have and your symptoms. If a medicine is causing your platelet disorder, your healthcare provider will ask you to stop taking that medicine. You will also need to treat the medical condition that is causing your platelet disorder. 

You may need one or more medicines to treat a low or high platelet count.

Medicines to treat high platelet count

• Anagrelide: This medicine can lower platelet counts in people who have a high risk of complications such as serious blood clots. This medicine may cause anemia and scarring of your bone marrow.
• Aspirin: This medicine helps prevent blood clots. Aspirin can raise your risk of bleeding.
• Hydroxyurea: This is used to reduce platelet counts. Possible side effects include making fewer blood cells, skin wounds, problems with your digestive system, and fever.
• Interferon-a and pegylated interferon: These medicines help reduce platelet counts. Side effects include extreme tiredness, flu-like symptoms, and confusion.

Medicine to treat low platelet count

• Anti-D immunoglobulin: This medicine is used to increase platelet counts in some people who have immune thrombocytopenia. Possible side effects include flu-like symptoms, low hemoglobin levels, and a breakdown of your red blood cells.
• Corticosteroids: These medicines help increase platelet counts. Corticosteroids include prednisone, prednisolone, and dexamethasone. This may be the first treatment your provider recommends for a low platelet count. Possible side effects include diabetes, insomnia, high blood pressure, digestive problems, mood changes, and slow growth in children.  
• Fondaparinux: This is used to treat heparin-induced thrombocytopenia (HIT). This medicine may cause bleeding, anemia, insomnia, dizziness, low blood pressure, and confusion.
• Immunosuppressors: These medicines stop your immune system from destroying your platelets. They are used to treat immune thrombocytopenia when corticosteroids do not work. Examples of this type of medicine include azathioprine, cyclophosphamide, cyclosporine, danazol, and dapsone. These medicines may increase your risk for infection. Other, less serious side effects can include loss of appetite, nausea, vomiting, increased hair growth, and hand trembling. These effects get better and may go away as the body adjusts to the medicine.
• Intravenous immunoglobulin (IVIG): This is used to increase your platelet count and treat major bleeding in immune thrombocytopenia. IVIG is also used to treat HIT. Complications may include serious allergic reactions and damage to your kidneys or lungs.
• Rituximab: This is an antibody treatment that may be used to treat immune thrombocytopenia or thrombotic thrombocytopenic purpura. This medicine may raise your risk of infections.  
• Thrombopoetin receptor agonist (TPO-RA) such as romiplostim and eltrombopag: These increase platelets in immune thrombocytopenia. They are used most often after other treatments have not worked. Possible side effects include low platelets, damage to the liver, venous thromboembolism, cataracts, bruising, and nosebleeds.

You may need one or more of the following procedures to treat your platelet disorder.

• Plasma exchange: This is used to treat thrombotic thrombocytopenic purpura. In this procedure, the liquid part of your blood (plasma) is replaced with donor plasmas using a machine that collects the cells in your blood.
• Plasma infusion: This is used to treat thrombotic thrombocytopenic purpura that is caused by your body not making enough of a protein called ADAMTS13. A plasma infusion helps replace the missing protein.
• Platelet transfusion: This procedure is used to quickly increase your platelet count when you are having serious bleeding. Possible complications include risk of infectious disease, allergic reaction, and difficulty with future transfusions. If you have HIT, a platelet transfusion can raise your risk of forming blood clots.  
• Plateletpheresis: This is used to treat life-threatening clotting in people who have high platelet counts. This procedure removes platelets from your blood and returns the liquid part of your blood (plasma) to your bloodstream.
• Bone marrow transplant: This procedure can help treat life-threatening types of platelet disorders. It is used to treat conditions that occur when the stem cells in your bone marrow do not make enough platelets.
• Surgery to remove your spleen (splenectomy): Your spleen is an organ in your upper left abdomen that stores platelets. Removing your spleen helps raise your platelet count. This helps treat a low platelet count. Possible complications include bleeding, infection, and blood clots.