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On Nplate. Platelet Count Over 125000. Can I Skip Injection If Count Is Above 100000. Suggestions?

Posted on Sun, 18 Aug 2013

Question: I have been on Nplate for 5 months after other therapies did not work. My platelet count has been over 125,000 for the past two months and over 150,000 the last month. My doctor has me receive an Nplate shot if my count is under 400,000. I have read that it is not to be used to raise my count, but to keep it over 50,000. Yesterday when I saw him I asked if I could skip my injection from now on if my count was above 100,000. He agreed to that because of my request, but he said it ha nt been done before. Have I made the right decision? I will still have blood work done every week.

Answered by Dr. Akhilesh Dubey (2 hours later)

Hi XXXXX,
Thanks for sharing your concern,

We should take great caution as in cases of ITP (Idiopathic thrombocytopenic purpura) platelet count decreases rapidly and can lead to bleeding diathesis.

This is good that you are responding to Nplate (Romiplostim) sub cutaneous injections, It is true platelet count should not go below 50, 000, to maintain at least this level is goal of treatment. Nplate may be withhold in count is more than 0000.
You certainly need to get your blood count every week.

It is my sincere advice to follow instructions of your Haematologist, please be watchful about your count and any red spots on skin or mucous membranes.
Please be vigilant and if you notice any bleeding like from gums or any other site, report it to your doctor immediately.

Hope this information is useful to you, if you have any doubt please ask me, I will be happy to help.
Take care.

Regards.
Dr. Akhilesh Dubey M.D.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar