Secondary Thrombocytosis Follow-up

Updated: Jul 10, 2020
  • Author: Devapiran Jaishankar, MBBS; Chief Editor: Srikanth Nagalla, MBBS, MS, FACP  more...
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Follow-up

Further Outpatient Care

In patients with secondary thrombocytosis (reactive thrombocytosis) for whom the causal comorbid condition has not been identified, maintain complete, careful outpatient monitoring with physical examination and routine laboratory tests to exclude the development of an occult disorder (eg, malignancy).

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Prognosis

In general, secondary thrombocytosis (reactive thrombocytosis) is a temporary laboratory anomaly that resolves when the primary causative condition is addressed. The overall prognosis in patients with secondary thrombocytosis reflects that of the underlying associated condition.

With certain disorders, however, (eg, chronic obstructive pulmonary disease [COPD], [21] ovarian cancer, [22]  esophageal cancer, [23]  colorectal cancer [24] ), the presence of thrombocytosis indicates a worse prognosis than for patients who do not have thrombocytosis. For example, Harrison et al reported that thrombocytosis was an independent risk factor for increased 1-year mortality after COPD exacerbations. Antiplatelet therapy was associated with significantly lower 1-year mortality in patients with secondary thrombocytosis and may have a protective role in acute exacerbations of COPD. [21]  

Similarly, in both early-stage and recurrent ovarian cancer, thrombocytosis is a poor prognostic sign. In recurrent ovarian cancer, an elevated platelet count at the time of secondary cytoreductive surgery was associated with suboptimal resection and poor overall survival, and thrombocytosis prior to chemotherapy was associated with lower response to chemotherapy and shorter survival. [22, 25]

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