Platelet transfusions

Platelets are tiny cells in your blood which form clots to help stop bleeding.  Cancer and some cancer treatments can affect the bone marrow where platelets are made. When this happens, the number of platelets in the blood becomes lower. This can increase your risk of bleeding and cause nosebleeds, bruising, heavier periods, bleeding gums or more serious problems.

If the number of platelets (your platelet count) is too low, doctors may recommend a platelet transfusion. If you consent, you will be given platelets collected from donors. The platelets are run through a drip and into your bloodstream. The transfusion usually takes 15-30 minutes and can usually be done at an outpatient clinic.

Severe side effects are rare, and all donated platelets are tested for infections or viruses. If you have any questions or concerns, talk to your doctor or nurse.

What are platelets?

Platelets are tiny cells in your blood which form clots to help stop bleeding. Cancer and some cancer treatments can affect the bone marrow where platelets are made. When this happens, the number of platelets in the blood becomes lower. This can increase your risk of bleeding and cause nosebleeds, bruising, heavier periods, bleeding gums or more serious problems.

If the number of platelets (your platelet count) is too low, doctors may recommend a platelet transfusion. If you consent, you will be given platelets collected from donors. The platelets are run through a drip and into your bloodstream. The transfusion usually takes 15-30 minutes and can usually be done at an outpatient clinic.

Severe side effects are rare, and all donated platelets are tested for infections or viruses. If you have any questions or concerns, talk to your doctor or nurse.


Why platelet transfusions are given

Sometimes the number of platelets (platelet count) in your blood may be low. Your platelet count may drop if your bone marrow is not working normally. This may be because you have cancer, leukaemia or a blood disorder. Treatment with chemotherapy, targeted therapies and sometimes surgery can also affect your platelet count. A type of radiotherapy called total body irradiation (TBI) can also affect your bone marrow and platelet count.

You will have regular blood tests during your cancer treatment to check the numbers of blood cells in your blood, including your platelet count. This test is called a full blood count (FBC). The normal platelet count in an adult is between 150 and 400. The risk of bleeding increases as the platelet count drops below this level. Signs of a low platelet count include:

  • nosebleeds 
  • bleeding gums 
  • heavy periods 
  • bruising 
  • tiny blood spots under the skin known as petechiae.

You should tell your doctor straightaway if you notice any of these symptoms.

Serious bleeding is rare and usually only happens if the platelet count is very low (below 10) or below 30 if you also have a high temperature. Your body uses up platelets faster if you have a high temperature.

Your doctors may recommend that you have a platelet transfusion if your platelet count is low. You may also have a platelet transfusion if your counts are low before a procedure where there is a risk of bleeding. This includes surgery, a lumbar puncture or bone marrow aspiration. The platelet transfusion will reduce the risk of any bleeding during or after the procedure.

If you are at home with a high temperature and think that your platelets could be low, contact the hospital on the emergency numbers you have been given.


Possible side effects

Reactions to the platelets

During the transfusion, you will have your temperature, pulse and blood pressure checked regularly by the nurses. This is to make sure you are not having a reaction. Common reactions can be shivering, a rise in temperature, itching or a skin rash.

The nurses will check you for any reactions. They’ll stop the transfusion and quickly treat any symptoms. Tell your nurse straight away if you feel unwell during your transfusion. Contact the hospital if you have any problems after you get home.

Becoming ‘refractory’ to platelets

Rarely, if you have had many platelet transfusions, they might not work as well for you and your platelet count may not improve after transfusion. This is known as becoming ‘refractory’ to platelets. If this happens you will have tests to find the cause. You may be given platelets that are better matched to your own.


Are platelet transfusions safe?

Some people worry that the platelets they are given may be infected by disease. People who donate blood or platelets are carefully screened for infections or viruses such as hepatitis or HIV. This is to make sure the donations are as safe as possible. All donated platelets are tested in the laboratory for infection. The risk of being given infected platelets is very small.

If you have any concerns about receiving a platelet transfusion, talk to your doctor or specialist nurse.


Back to Supportive therapies

Blood transfusions

Some cancers or cancer treatments can cause anaemia, which is a low number of red blood cells. Blood transfusions are used to treat anaemia.

Erythropoietin

Erythropoietin helps the bone marrow to make red blood cells. It can be used to treat anaemia caused by cancer or its treatment.

G-CSF

Having chemotherapy can make you more prone to infections. G-CSF helps you make more white blood cells to reduce that risk.

Nephrostomy

A nephrostomy is a tube that drains urine from the kidney if there is a blockage in your urinary system.

Plasma exchange

Plasma exchange (sometimes called plasmapheresis) is a supportive treatment used for myeloma and a rare type of lymphoma called Waldenström's macroglobulinaemia.

Steroids

Steroids can be used as part of cancer treatment or to help with the side effects of treatment.