Low Platelets

[Janet02]

I have Follicular Lymphoma. A week before I started Chemo I was in the hospital and diagnosed with Thrombocytepenia. My platelets dropped to 3,000. I did not respond to platelet therapy but did respond to IVIG. My last chemo was in 02/2008. My platelets are still giving me trouble. I have an IVIG treatment every 2-3 weeks. How long can this last? I usually get flu symptoms 3 days post IVIG. It is hard to take care of my children and work a full time job. I am always so drained and tired. I gained a lot of weight because I was on high doses of prednisone. Has anyone experienced anything like this and can give me a guess when this will taper off? I want to lose this extra weight but feel so drained after work.

[Fernando Roque, MD]

Hi.  If your platelet counts increase when you're given intravenous immunoglobulins (IVIG), this probably means that your tumor is producing anti-platelet antibodies, which are inhibited when IVIG is given (the IVIG binds to the anti-platelet antibodies, thus inactivating them).  Since your thrombocytopenia is likely because of the tumor, the best way to resolve the low platelet count is to treat the tumor itself with chemotherapy.  But chemotherapy can only be done safely if your platelet counts are high enough, hence the need for intermittent IVIG treatment.  

So to answer your question: your weakness and weight gain will begin to resolve once you stop receiving IVIG and steroids.  These medications will only stop when you stop having episodes of thrombocytopenia. The thrombocytopenia will hopefully resolve once the tumor starts responding to the chemotherapy.

[Janet02]

My Doctor said I am in remission. My last chemotherapy was 02-15-08. I was getting IVIG treatments every 2-3 weeks. The longest I have gone is 5 weeks. How long is the chemo in my system for the tumor to respond? The IVIG treatments make me sick. I get an excruciating headache that lasts for 3 days and the chills. Is it possible that this is something I will have to deal with the rest of my life?

[Fernando Roque, MD]

Hi Janet. The IVIG treatments are most probably temporary, but I can't tell for certain how long it's going to last.  It really depends on the persistence of your thrombocytopenia.  If the episodes of thrombocytopenia continue to be recurrent, then maybe an examination of your bone marrow may be warranted to check for the possibility of lymphoma infiltration.