Platelets are necessary to repair the body and to stop bleeding through the formation of clots. Because platelets are produced by the bone marrow, platelet counts decrease when a child is on chemotherapy. Signs of lowering platelet counts are small vessel bleeding such as bruises, gum bleeding, or nosebleeding. Platelet transfusions may be given when the count is very low (between 10,000 and20,000 mm3) or when there is bleeding. Platelets are counted by passing a blood sample through an electronic device.
Approximately one-third of all platelets spend a great deal of time in the spleen. Any splenic dysfunction such as enlargement may cause the counts to drop precipitously. If the spleen is removed, platelet counts may skyrocket. This transient thrombocytosis (elevated platelet count) will abate within a month.
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