The problem of thrombocytopenia and its management.

The management of treatment-induced thrombocytopenia has become an important health care issue as a result of using intensive chemotherapy in an increasing range of malignant diseases. The problems of using pooled blood products is putting a strain on resources and producing its own medical complications. The advent of cloned cytokines has opened the era of manipulation of the megakaryocyte line and it is hoped that this will mimic the benefits seen in respect of white cell and red cell cytokine control. However, many questions remain to be answered as the complexity of the cytokine targets and interactions are being revealed by current clinical research. A thrombocyte stimulation/maturation product equivalent to granulocyte-colony stimulating factor or erythropoietin has only recently been identified and awaits clinical evaluation.