Multiple myeloma causes an overgrowth of cancerous plasma cells in your bone marrow. When these cancerous cells crowd out the healthy cells in your bone marrow, thrombocytopenia can occur.

Multiple myeloma is a blood cancer that forms in the plasma cells of your bone marrow. Plasma cells are a kind of white blood cell that creates antibodies.

As cancerous plasma cells reproduce, they crowd out healthy plasma cells, making it difficult for your body to fight infection effectively. The overproduction of plasma cells also leads to a range of other complications, including low platelet counts or thrombocytopenia.

Read on to learn more about thrombocytopenia caused by multiple myeloma, including symptoms and treatment.

Mild thrombocytopenia doesn’t always cause symptoms. Your doctors might notice it during routine bloodwork as part of your multiple myeloma treatment. When thrombocytopenia does cause symptoms, they can include:

Potential risks of thrombocytopenia

Thrombocytopenia can put you at risk of severe bleeding. This can be external bleeding, like a wound that won’t stop bleeding. It can also be internal bleeding, like a brain bleed that doesn’t clot and stop.

In either situation, this complication of thrombocytopenia requires urgent medical care. Without treatment, this bleeding could be fatal.

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Some symptoms of thrombocytopenia, like weakness and fatigue, might be hard to notice because they’re also symptoms of multiple myeloma.

But multiple myeloma on its own won’t cause symptoms like easy bruising and bleeding or blood in the urine. These symptoms indicate that you’ve developed thrombocytopenia as a complication.

Additional symptoms can occur from the complications of multiple myeloma. These include:

  • anemia
  • kidney failure
  • high blood calcium levels or bone metastasis (when cancer spreads to the bone)
  • loss of appetite
  • unintentional weight loss
  • excessive thirst
  • constipation
  • nausea
  • mental fog
  • bone pain, primarily in the spine
  • numbness or tingling in your legs

If you’re having symptoms of thrombocytopenia, your doctor might order a blood test called a complete blood count. A complete blood count measures the number of red blood cells, white blood cells, and platelets in your blood.

A healthy platelet count is 150,000 to 450,000 platelets per microliter of blood. Any platelet count below 150,000 is thrombocytopenia, but mild thrombocytopenia doesn’t typically need to be treated.

If your platelet count falls below 50,000, you’ll be at risk for severe complications of thrombocytopenia. Your doctor will likely suggest treatment to prevent these complications and treat your symptoms.

One of the primary treatments for thrombocytopenia in multiple myeloma is a platelet transfusion. A platelet transfusion is used for symptomatic bleeding or a platelet count below 10,000 per microliter of blood.

A platelet transfusion procedure is the same as the procedure for a standard blood transfusion. You’ll be hooked to an IV line, and treatment will take between 15 and 30 minutes.

The treatment increases your platelet count instantly, although it only has a temporary effect. You might need multiple platelet transfusions throughout the course of your multiple myeloma treatment.

Treating your multiple myeloma will also help treat thrombocytopenia. As treatments destroy cancer cells, there will be more space in the bone marrow to make healthy blood cells. This will allow your body to make new platelets again and can resolve thrombocytopenia.

Thrombocytopenia isn’t the only complication of multiple myeloma. Multiple myeloma can also lead to complications, like:

  • Bone problems: Multiple myeloma can cause weak bones, bone pain, and easily broken bones.
  • Kidney problems: Multiple myeloma can make it difficult for your kidney to function and can even lead to kidney failure.
  • Nerve problems: Multiple myeloma can attack the nerves. Solitary tumors of multiple myeloma can also push against the spine, leading to complications like tingling, pain, and weakness. Treatments for multiple can also carry a side effect of nerve problems.
  • Anemia: Multiple myeloma can reduce your red blood count and can lead to amenia.
  • Infections: Multiple myeloma can make it hard for your body to fight off bacteria, viruses, and other disease-causing microbes. This can put you at risk for frequent infections.
  • Hypercalcemia: Hypercalcemia is increased calcium in the blood. Multiple myeloma can lead to this complication that causes symptoms like confusion and nausea.
  • Depression: Multiple myeloma can lead to depression, anxiety, and other mood conditions.

Thrombocytopenia can be a complication of multiple myeloma. Symptoms of thrombocytopenia include easy bleeding, easy bruising, weakness, and fatigue.

Thrombocytopenia will often improve as treatment for multiple myeloma progresses and your body is able to make new and healthy platelets.

If your platelet count is very low, you might have one or several platelet transfusions. A platelet transfusion can replace the platelets you’ve lost and can help treat your symptoms until your body is able to make its own platelets.