low platelets

[cheryl4WD]

i'm stage IV and have been on Xeloda for the last 18 months, but my TMs are rising so we have been discussing having chemo..  when I went for my last blood test, I was shocked to learn that my  platelets had dropped by 110 points in just 6 weeks and then in the 7th week they dropped by a further 6 points.  now down to 50.

has anyone had any experience in this area.  oncologist not sure if its bone marow mets, autoimmune or the xeloda thats bringing them down.  

[Dennis MD]

Hi.
I agree with your oncologist.  The decrease in platelet count can be due to bone marrow involvement by cancer or secondary to intake of capecitabine (xeloda).  The possibility of it being secondary to an autoimmune disorder can also be considered.  In the setting of cancer, oncologists are more inclined to think of it as being secondary to treatment or to disease progression (bone marrow involvement).  
A bone marrow aspiration biopsy may help rule out the presence of bone marrow involvement.  Stopping the drug intake can also be done and see if the platelet count will increase.  Work-ups for autoimmune disorder can also be done.  
Shifting t another chemotherapy drug/s can be done.  However, this may further decrease the platelet count since chemotherapy drugs are myelosuppressive.
Hope this helps.  

[cheryl4WD]

Thanks for your answer Dennis, if its the Xeloda, just giving the body a rest for a few weeks will hopefully let the platelet count rise  BUT

if it is bone marrow mets. how do you treat, as the bone marrow mets gives you a low platelet count and as such you cannot have chemo with a low platelet, seems to be a catch 22.

I would think there are people out there with bone marrow mets, what do they do???