Sorry I meant
....open to 'interpretation'.
Hector
Treatment with Incivek, peg-interferon and ribavirin reduces platelet counts.
When you say low that is open to intuition. What numbers do you mean by high and low. There are different levels of low platelet counts. Depending on what the numbers are tells if their is need for concern.
Platelets are produced in the bone marrow, the same as the red cells and most of the white blood cells. The average lifespan of a platelet is normally just 5 to 9 days. Platelets are a natural source of growth factors. They circulate in the blood of mammals and are involved in hemostasis, leading to the formation of blood clots.
If the number of platelets is too low, excessive bleeding can occur. However, if the number of platelets is too high, blood clots can form (thrombosis), which may obstruct blood vessels and result in such events as a stroke, myocardial infarction, pulmonary embolism or the blockage of blood vessels to other parts of the body, such as the extremities of the arms or legs.
Thrombocytopenia (a low platelet count) is defined as a platelet count < 150,000 cells/µL.
'Moderate thrombocytopenia' is a platelet count of 50,000-75,000 cells/µL. It can increase the risk of bleeding during invasive procedures such as liver biopsy, particularly in patients with coexistent coagulopathy. A high PT/INR time. If a patients platelet count show moderate thrombocytopenia it may prevent optimal therapy of chronic HCV infection with peginterferon-based therapy. This is one factor that affects patients with cirrhosis who commonly have platelet counts in this range. Since 2008 when I was diagnosed with cirrhosis I have never had a platelet count higher then 70,000.
In patients with advanced cirrhosis, 'severe thrombocytopenia' is associated with life-threatening complications and has been recognized as a risk factor for developing complications of cirrhosis, such as variceal bleeding and death.
Thrombocytopenia in patients with HCV-related chronic liver disease or with persons treating with currently available hep C treatments is complex and involves the interaction of multiple factors. In general, these factors may be grouped into disease-related factors and treatment-related factors. Factors related to the disease include hepatic fibrosis or cirrhosis, hypersplenism (an enlarged spleen), bone marrow suppression (where platelets are made), immune dysfunction, and decreased thrombopoietin levels or activity.
The product labels for both formulations of peginterferon recommend dose reductions for patients with platelet counts between 50,000 and 80,000 cells/µL and discontinuation of therapy if platelet counts fall below 25,000-50,000 cells/µL. Treatment with peginterferon has been shown to reduce platelet counts by up to 33%. Therefore, even in patients with adequate platelet counts before therapy, decreases in platelet counts may occur during therapy, which could require a dose modification that may ultimately lower the chances of attaining sustained virologic response. Again, more experienced physicians may be less aggressive in dose modifications with cautious monitoring and the use of treatments to manage platelet count reductions.
You say that you feel well. Which makes sense as a low platelet count only effects the ability of your blood to clot. It has no mental or other physical symptoms.
So it depends on how low your platelet count is in real number to determine if dose reductions are required or other interventional treatments or treatment stopped (when platelet count goes below 20,000). Of course your gastro or hepatologist should be on top of this. That is why try are having the platelet count tested.
Good luck with your treatment!
Cheers!
Hector
Our platelets are used to clot blood. If your platelets get below 50, you can be at risk of bleeding internally. Below 20 is more dangerous, where "bleeding out" can occur spontaneously, due to lack of clotting ability.
I dont know about mean platelets though.