Thrombocytopenia in palliative care

Thrombocytopenia can frequently be asymptomatic, but signs may include bruising, purpura or overt bleeding. In patients with palliative care needs who have isolated thrombocytopenia, the risk of bleeding is usually low but ongoing.

Management of thrombocytopenia depends on the cause. Consider the potential benefits and burdens of each intervention, and the patient’s prognosis, preferences and goals of care—see Principles of symptom management in palliative care.

If heparin-induced thrombocytopenia (HIT) is suspected, see the Cardiovascular guidelines for management.

In patients with palliative care needs, platelet transfusions, if feasible to administer, may help stop the distressing symptom of bleeding; however, prophylactic platelet transfusions are rarely necessary.

For general management of bleeding, see Bleeding in palliative care.