Thrombocytopenia and Bleeding in Patients With Oncologic Emergencies Following Cancer Therapy

There is a lack of studies investigating Cancer therapy-induced thrombocytopenia (CTIT) and the risk factors predicting CTIT-related hemorrhage in the emergency oncology patient population. This study aimed to present Chinese data on CTIT and organ bleeding in patients undergoing emergency oncology.

This retrospective study was conducted in the Oncology Emergency Department. We evaluated the clinical features and outcomes of CTIT and associated organ hemorrhage.

A retrospective analysis collected data from 8590 cases of malignant tumor emergency visits. Among these, 1164 cases (13.5%) of CTIT met the inclusion criteria, with a median patient age of 61 years. 61 (5.24%) of the 1164 CTIT cases were associated with overt organ hemorrhage. Independent risk factors predicting CTIT deterioration included Eastern Cooperative Oncology Group (ECOG) score of 2-4 (odds ratio [OR] = 4.883), stage IV (OR = 2.275), organ bleeding (OR = 3.029), anemia (OR = 3.243), and fever (OR = 5.360), all with p < 0.05. Among the 61 cases with bleeding, 41% (25/61) involved lung cancer. The bleeding group had a significantly higher proportion of patients with fever (11.5% vs. 2.9%), pleural effusion (25.0% vs. 9.8%), and malnutrition requiring parenteral nutritional support (9.8% vs. 2.8%) compared to the non-bleeding group (p < 0.05). Fever (OR = 4.886, p = 0.003) and pleural effusion (OR = 4.812, p = 0.007) were identified as independent risk factors for CTIT-related bleeding.

Malignancies associated with reduced platelet counts and additional risk factors require heightened clinical vigilance for hemorrhage development.