Incidence of cancer chemotherapy-induced thrombocytopenia and its treatment outcomes at an oncology centre
K. Archana, J. Jaicey Cathorine, K. BhuvaneswariABSTRACT
Background:
Chemotherapy-induced thrombocytopenia (CIT) is a common haematological adverse effect in patients with cancer receiving cytotoxic chemotherapy. It is associated with an increased bleeding risk, treatment delays, dose reductions and compromised therapeutic outcomes. Despite global studies on CIT, data from South Indian tertiary care hospitals remain limited, necessitating institution-specific evidence to guide clinical decision-making.
Aim:
The study aimed to evaluate the incidence, severity grades and management outcomes of CIT amongst cancer patients and to identify the most common chemotherapeutic agents implicated.
Materials and Methods:
After approval by the Institutional Human Ethics Committee, we conducted a retrospective observational study over 1 year at a tertiary care oncology centre. Data were collected from the electronic medical records of 150 cancer patients who had received at least three cycles of chemotherapy and had complete haematological data. Platelet counts before and after chemotherapy were recorded, and thrombocytopenia was graded according to the Common Terminology Criteria for Adverse Events. Management strategies were analysed, including dose modification, treatment delay, platelet transfusion and thrombopoietin receptor agonist (TPO-RA) use.
Results:
CIT was frequently observed amongst patients receiving platinum-based regimens, accounting for 48.6%. Platinum coordination complexes, particularly carboplatin, caused CIT in 24% of patients and were associated with the highest incidence of thrombocytopenia. Grade 1 CIT accounted for 82% of CIT cases, Grade 2 for 9%, Grade 3 for 3% and Grade 4 for 6%. Severe cases were managed with romiplostim and/or platelet transfusion. Mild-to-moderate cases were managed conservatively. High treatment costs limit the routine use of TPO-RAs.
Conclusion:
CIT remains a significant clinical challenge, particularly with platinum-based chemotherapy, especially carboplatin. Most cases are mild and self-limiting; however, severe thrombocytopenia requires active intervention. Early identification, grading and structured management of CIT can help prevent complications, reduce unnecessary treatment delays and improve overall patient outcomes.