What is thrombocythemia?

Thrombocythemia is a disease in which your bone marrow makes too many platelets. Platelets are tiny blood cells that help with blood clotting. Having too many platelets makes it hard for your blood to clot normally. This can cause too much clotting or not enough clotting.

What causes thrombocythemia?

There may be no single cause for thrombocythemia. It is believed to be a genetic problem that causes defects in the bone marrow’s platelet-making cells.

What are the symptoms of thrombocythemia?

Symptoms of thrombocythemia include:

• Blood clots in arteries and veins, most often in the hands, feet, and brain. But they can happen anywhere in the body.

• Bruising easily

• Bleeding from the nose, gums, and GI (gastrointestinal) tract

• Bloody stools

• Bleeding after injury or surgery

• Weakness

• Headache and dizziness 

The symptoms of thrombocythemia may look like other blood disorders or health problems. Always see your healthcare provider for a diagnosis.

How is thrombocythemia diagnosed?

Your healthcare provider will take your health history and give you a physical exam. You will also have tests, such as:

• CBC (complete blood count). This test measures the amount of red blood cells, white blood cells, and platelets in your blood.

• Blood smear. This test looks at the blood cells using a microscope.

• Bone marrow aspiration or biopsy. This test may be done to see if your bone marrow is healthy. It involves taking a small sample of bone marrow fluid (aspiration) or solid bone marrow tissue (core biopsy). This sample of fluid or tissue is examined under a microscope.

• Genetic testing. This blood test checks for mutations or changes in the genes that control how platelets are made in the body.

How is thrombocythemia treated?

Treatment will depend on your symptoms, age, and general health. It will also depend on whether you have had a blood clot or how severe the condition is.

Treatment generally is done to ease symptoms and reduce the risk of having blood clots. Treatment may include:

• Low-dose aspirin. This medicine is used to help prevent blood clots. It is mostly for people who have a low risk for clots.

• Chemotherapy. This treatment often may be given as a pill or injected. The standard treatment is the oral chemotherapy medicine called hydroxyurea. Other medicines sometimes used include anagrelide or interferon alpha. 

• Plateletpheresis. This procedure quickly removes platelets from your blood. This procedure is mostly used for emergencies, such as a stroke.

Living with thrombocythemia

Work with your healthcare provider to develop a treatment plan that meets your needs.

 It’s also important to:

• Not smoke, which may increase the risk of blood clots. Ask your healthcare provider for help quitting.

• Control other health conditions, such as high cholesterol, high blood pressure, and diabetes

• Tell your healthcare provider if you notice bruising or other signs of bleeding

Key points about thrombocythemia

• Thrombocythemia is a disease that causes your body to make too many platelets in the bone marrow.

• Too many platelets can cause blood clots or bleeding.

• Symptoms include blood clots and signs of bleeding, such as bruises, bloody stools, and weakness.

• There may be no single cause for the disease. It is believed to be a genetic problem that causes defects in the bone marrow’s platelet-making cells.

• Treatment includes medicines to control the platelet count and, in emergency cases, quickly removing platelets from the blood.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new directions your provider gives you.

• Know why a new medicine or treatment is prescribed and how it will help you. Also know what the side effects are and when they should be reported.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your healthcare provider if you have questions, especially after office hours or on weekends.