Chemotherapy-induced thrombocytopenia

CIT is a common complication of antineoplastic therapy, characterized by a decrease in platelet count, which can lead to treatment delays, dose reductions, and discontinuation of therapy due to the risk of bleeding events.

The pathophysiology of CIT involves the direct toxic effects of chemotherapy on bone marrow, specifically on megakaryocytes, which leads to decreased production of new platelets. Additionally, chemotherapy can increase the rate of platelet destruction, further contributing to the reduction in platelet count.

Risk factors for CIT include the type of cancer, the specific chemotherapy regimen used, and individual patient characteristics. CIT is more common in patients with hematologic malignancies (approximately half of cases) than in those with solid tumors (about one-third). Thrombocytopenia is reported in 37% of patients receiving gemcitabine and 31% of those treated with platinum-based chemotherapy. Other potential risk factors are renal impairment or liver disease, advanced age, and baseline platelet count.