title: Treatment patterns and outcomes in management of solid cancer patients suffering from thrombocytopenia in Penang hospital.
abstract: BACKGROUND
  Thrombocytopenia denotes abnormal decreases in platelet numbers and is a major detrimental side effect of the chemotherapy or cancer disease itself which cal lead to hemorrhage from vital organ. This is particularly a problem for the brain specifically within solid cancer patients and has a great negative effect on cancer patients quality of life (QOL). It ranges from mild bleeding from small blood vessels to severe bleeding from large blood vessels. The present study was conducted to evaluate the effectiveness of treatment guidelines for thrombocytopenia among solid cancer patients in Penang hospital and to find associations between these treatments and thrombocytopenia onset and severity and to suggest changes in the guidelines.
  
  
  METHODS
  This retrospective observational study, conducted in a government hospital on Penang island included 341 cancer patients with thrombocytopenia who were admitted in the period between 2003 to 2009. The main statistical tests used were Chi-square test and Logistic regression test. The level of significance was set at P < 0.05.
  
  
  RESULTS
  Of the total of 341, 21 (6.2%) showed thrombocytopenia before receiving chemotherapy and the remaining 320 (93.8%) after chemotherapy. The majority suffered from moderate thrombocytopenia (n=172; 53.8%), followed by mild a (n=97; 30.3%) and finally severe (n=51; 15.9%). For treatment, chemotherapy was delayed/ reduced (n=223; 65.4%) or platelets were transfused (n=51; 34.6%). However, thrombocytopenia problems were only temporarily solved.
  
  
  CONCLUSIONS
  Effectiveness of thrombocytopenia treatment guidelines was found to be insufficient. It is advisable that thrombopoietin be used as a cornerstone even for patients who suffer from moderate thrombocytopenia and platelets transfusion should be used just for emergency cases when thrombocytopenia leads to a critical situation.
authors.affiliation: Clinical Pharmacy Discipline, School of Pharmaceutical Sciences, University Sains Malaysia, Minden Penang, Malaysia. bassamsunny@yahoo.com
authors.forename: Bassam Abdul Rasool
authors.initials: BA
authors.lastname: Hassan
authors.forename: Zuraidah Binti Mohd
authors.initials: ZB
authors.lastname: Yusoff
authors.forename: Mohamed Azmi
authors.initials: MA
authors.lastname: Hassali
authors.forename: Saad
authors.initials: S
authors.lastname: Bin Othman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001792:Blood Platelets; D005260:Female; D006801:Humans; D008296:Malaysia; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D017713:Platelet Transfusion; D012189:Retrospective Studies; D013921:Thrombocytopenia / Q000150:complications / Q000188:drug therapy* / Q000473:pathology / Q000628:therapy*; D013926:Thrombopoietin / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D013926:Thrombopoietin