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Chemotherapy Induced Thrombocytopenia: Is it Inducing Additional Social, Economic and Clinical Burden?

N. Anwar1, N. Fatima1, H.-u.- Mujtaba1, T. Shamsi1

1National Institute of Blood Diseases and Bone Marrow Transplantation, Karachi, Pakistan

Abstract Number: PB0752

Meeting: ISTH 2021 Congress

Theme: Role of Hemostatic System in Cancer, Inflammation and Immunity » Platelets and Cancer

Background: Chemotherapy induced thrombocytopenia (CIT) is perilous and may complicate the chemotherapeutic treatments resulting in extended hospitalization, bleeding, transfusion and the economic burden. Typically patients with hematological malignancies (HM) are at high risk of bleeding as well as thrombosis which may lead to poor overall survival and disease outcome.  Our center is a referral institute for blood disorders where a significant number of patients undergo chemotherapeutic treatment having frequently encountered malignancies as leukemia, lymphoma and myeloma.

Aims: This study was designed to observe the incidence of CIT and its clinical, social and economical consequences.

Methods: This was a retrospective cohort study conducted at NIBD PECHS campus from January-December 2019. Study population comprised of patients with HM receiving chemotherapy. The incidence of CIT and its resultant clinical, social and economic consequences were evaluated.  

Results: A total of 63   chemotherapeutic cycles for HM were analyzed. Median and range of age of patients was 42(9-75years) with predominance of males 47(75%). The overall incidence of CIT was 18%. The odds ratio for leukemia protocol regimen observing CIT was higher 2.557 (95% CI: 1.565-4.177) than non leukemic regimen 0.267(95% CI: 0.075-0.950). The median length of hospital stay was 4(1- 14)days, bleeding was present in 6(16%) patients and median of 3.5 units of platelet were transfused. Voluntary donations were only 5(3%). The approx cost of CIT related admissions was 30,365PKR (US$196) per patient.

Conclusions: In conclusion, CIT may lead to additional clinical, social and economic burden on patients. In a developing country where voluntary donations are scarce and people are vulnerable to get treatment of primary disease, these social affairs are also an additive burden. Additional measures like education for voluntary donations, blood camps for patients residing in remote areas and prophylactic tranexamic acid are needed to be formerly addressed especially in leukemia patients to minimize the consequences of CIT.

To cite this abstract in AMA style:

Anwar N, Fatima N, - Mujtaba H-, Shamsi T. Chemotherapy Induced Thrombocytopenia: Is it Inducing Additional Social, Economic and Clinical Burden? [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/chemotherapy-induced-thrombocytopenia-is-it-inducing-additional-social-economic-and-clinical-burden/. Accessed May 16, 2022.

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