"Does leukemia always result in low platelet counts?"

Leukemia and Platelet Counts

During acute phases of leukemia, platelet counts generally decrease. However, in conditions such as chronic myeloid leukemia (CML), myelodysplastic syndromes (MDS), and hypersplenism, platelets may exhibit mild reductions, yet not all leukemia patients experience decreased platelet levels.

1. Acute Myeloid Leukemia (AML)

Due to the proliferation of leukemia cells within the bone marrow, normal hematopoiesis is disrupted, and the normal hematopoietic function of the bone marrow is inhibited. Consequently, AML patients commonly exhibit decreased platelet counts. To address this, clinical treatment involves regular administration of tyrosine kinase inhibitors like imatinib and nilotinib to manage disease progression.

2. Chronic Myeloid Leukemia (CML)

CML patients may have decreased platelet counts due to abnormal bone marrow hematopoiesis. However, mild reductions can still remain within normal levels. Chemotherapy and targeted therapies are administered to control the disease, and platelet counts naturally return to normal once the patient's condition stabilizes.

3. Myelodysplastic Syndromes (MDS)

Leukemia cells can infiltrate other bone marrow cells, leading to abnormal hematopoiesis and inhibiting platelet production, resulting in low platelet counts. Glucocorticoids like dexamethasone and prednisone acetate are recommended for treatment.

4. Hypersplenism

Enlarged spleens can damage platelet follicles, leading to decreased immune function and subsequently low platelet counts. Immunosuppressive therapies, such as cyclophosphamide and azathioprine, are advised for splenomegaly patients. Once the spleen shrinks, platelet counts gradually normalize.

Additionally, the use of tyrosine kinase inhibitors and anti-angiogenic targeted drugs may also lead to decreased platelet counts. When low platelet counts are observed, it's crucial to differentiate between disease-related and drug-induced causes, based on clinical symptoms and relevant examinations, for timely management.