Bruising and Bleeding


Bruising and bleeding more easily than normal may be a side effect of your cancer treatment. The most common reason for cancer patients to experience excessive bruising or bleeding is a low platelet count, a condition also referred to as thrombocytopenia. Platelets are necessary for blood clotting. If thrombocytopenia is determined to be the cause of your bruising and bleeding, you may be given a platelet transfusion or prescribed a blood cell growth factor, which stimulates your bone marrow to produce more platelets and helps prevent low platelet counts after chemotherapy.

How are bruising and bleeding similar?

Bleeding is loss of blood outside the body or into a body cavity. A bruise, also called a purpura (if flat) and a hematoma (if large), is bleeding into the skin from damaged blood vessels, causing a black and blue appearance.

What causes bruising and bleeding?

Bruising and bleeding are usually caused by some kind of trauma or injury. However, certain underlying conditions may cause you to bruise or bleed more easily than normal. The most common reason for this in cancer patients is a low platelet count, a condition also referred to as thrombocytopenia.

Platelets, also called thrombocytes, are fragments of blood cells which are found in the circulating blood and are critical for stopping bleeding. Platelets plug the small holes that form in blood vessels daily and work with other blood factors to form a blood clot, which stops bleeding in larger blood vessel injuries.

There are, however, many other possible causes for bruising and bleeding, including several other bleeding disorders that are caused by a lack of various blood factors that are essential for clotting.

What are the symptoms of a low platelet count?

Here are some clues that may indicate that you have a low platelet count or another bleeding disorder.

  • You bleed excessively and even a small cut bleeds for a long time.
  • You may develop small red dots on the surface of your skin, especially on your legs, which are called petechiae.
  • You have excessive bruising, including many purplish spots under the skin even when you haven’t had an injury.
  • You may have frequent nose bleeds or bleeding from your gums and mouth.

Notify your doctor immediately if you have any of these symptoms.

What is the treatment for bruising and bleeding?

If the bruising and bleeding you are experiencing is determined to be a consequence of a low platelet count, your doctor may prescribe a blood cell growth factor. Blood cell growth factors are substances produced by your body to stimulate the bone marrow to produce more platelets. They are usually prescribed to help prevent low platelets. If you have a severely low platelet count, you may require treatment with platelet transfusions and, occasionally, admission to the hospital until the platelets return to sufficient levels in the blood to prevent bleeding.

Neumega® (oprelvekin) - This is the blood cell growth factor approved by the U. S. Food and Drug Administration for the prevention of a low platelet count. Clinical studies have shown that oprelvekin prevents thrombocytopenia and decreases the need for platelet transfusions in some patients at high risk for developing a low platelet count.

Platelet transfusion - A platelet transfusion is the addition of platelets into your blood from an outside source, such as a blood bank. Platelet transfusions do carry the risk of complications, including allergic reactions that may range from mild to life threatening. In general, it is better to prevent a low platelet count than to treat it once it occurs.

This content was last reviewed August 15, 2010 by Dr. Reshma L. Mahtani.
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