Thrombocytopenia is a common complication of chronic lymphocytic leukemia (CLL). It causes excessive bleeding and could indicate that CLL is progressing.

CLL is a subtype of leukemia, or blood cancer. It’s the most common type of leukemia in adults, but it’s rare in children.

CLL primarily affects your bone marrow by creating an unusually large number of white blood cells called lymphocytes. However, it’s also possible for CLL to cause low platelets (thrombocytopenia).

Understanding the symptoms of low platelets is important in detecting CLL-related thrombocytopenia early. It’ll help a doctor promptly offer an accurate diagnosis and treatment plan.

Thrombocytopenia means you have a low platelet count. Platelets help your blood clot to prevent excessive bleeding after an injury.

Although some types of thrombocytopenia have no identifiable cause (idiopathic), certain underlying conditions can also cause low platelets. These include autoimmune conditions and cancers such as CLL.

CLL may cause thrombocytopenia due to an overcrowding of lymphocytes in your bone marrow, which then creates a lack of space for new platelets to form.

Thrombocytopenia may also be due to autoimmune problems that develop in CLL. In such cases, your immune system attacks your bone marrow and healthy blood platelets, leading to low counts.

In some cases, thrombocytopenia may develop from CLL treatments, such as chemotherapy and radiation therapy.

If you have thrombocytopenia related to CLL or another underlying cause, you may notice that you bleed easier than usual. A minor bump or scrape can lead to excess bleeding or even bruising. It’s also possible to develop bruises without any known injuries.

Additionally, you may experience:

Thrombocytopenia also has key clinical signs. Among them are flat, dark spots in the shape of pinpoints along your skin called petechiae. These result from bleeding underneath your skin. The color of these spots can vary based on your natural skin tone.

These signs and symptoms may develop along with other CLL symptoms, including:

  • swollen lymph nodes
  • fatigue
  • fever
  • frequent infections
  • unintentional weight loss
  • abdominal pain or fullness due to an enlarged liver or spleen

When to contact a doctor

It’s important to contact a doctor if you’re experiencing easy bleeding and bruising or if you have possible petechiae on your skin. They can help determine whether you have thrombocytopenia related to CLL or another potential cause of low platelets.

Doctors diagnose thrombocytopenia with a physical exam and blood tests. First, they’ll look at your skin for signs of petechiae, and they’ll ask you about any unusual bleeding and bruising you may be experiencing.

A complete blood count (CBC) can confirm clinical signs of thrombocytopenia. This test measures platelet levels as well as red and white blood cells.

A typical platelet count ranges from 150,000 to 450,000 per every microliter of blood. Experts consider anything under 150,000 platelets per microliter as low.

In some cases, a doctor may diagnose thrombocytopenia with a blood test before you even experience symptoms of low platelets. This might occur during a routine blood test for CLL. Typically, the lower your platelet count, the more likely you are to have signs and symptoms.

Doctors usually treat asymptomatic CLL with watchful waiting, which involves monitoring your symptoms and recommending periodic CBCs. Once you have symptoms, such as those from thrombocytopenia, a doctor may diagnose progressive (symptomatic) CLL.

At this point, treatment may be necessary to help stop lymphocytes from causing further problems in your body. Treatment options for symptomatic CLL may include:

Treating CLL will also help your bone marrow recover so that it can produce new and healthy blood platelets.

Certain treatments, such as immunosuppressants, can also help manage CLL-related idiopathic thrombocytopenic purpura. These work by preventing your immune system from attacking newly formed blood platelets in your bone marrow.

Experts consider CLL a difficult-to-cure but slow-progressing form of leukemia. The presence of thrombocytopenia might mean that lymphocytes have increased throughout your bone marrow, which is one possible sign of cancer progression.

Thrombocytopenia can also vary in severity. If a doctor diagnoses this condition, they may recommend that you take precautions to prevent severe — and potentially life threatening — bleeding. This could include avoiding certain activities that may increase the risk of injury, such as:

  • playing contact sports
  • driving without a seatbelt
  • getting major dental procedures
  • smoking

You may not necessarily be able to prevent thrombocytopenia from developing with CLL. However, you can keep up with your recommended follow-up visits so that a doctor can detect low platelets before this complication worsens.

What types of leukemia cause low platelets?

Any type of leukemia can cause low platelets due to the presence of cancer cells in the bloodstream and bone marrow. But not everyone with leukemia or CLL will develop thrombocytopenia.

What are the most common complications of CLL?

Thrombocytopenia is one possible complication of CLL. Other complications include increased infections, anemia, and secondary cancers, such as lymphoma.

Autoimmune hemolytic anemia is a more common complication of CLL than immune thrombocytopenia.

Is thrombocytopenia a sign that CLL is progressing?

Early cases of CLL don’t cause any signs or symptoms, including those associated with low blood platelets. If a doctor diagnoses thrombocytopenia with blood testing and symptom observation, it could be related to CLL progression.

Thrombocytopenia is a common complication of CLL. Possible causes include increased lymphocytes, autoimmune condition development, or CLL treatments.

A doctor can detect thrombocytopenia with a CBC, but it’s also important to call them right away if you experience any possible symptoms of low platelets. This is a serious, potentially life threatening condition that can cause severe bleeding.