How I diagnose and treat thrombocytopenia in geriatric patients

Blood. 2024 Jan 18;143(3):214-223. doi: 10.1182/blood.2022017634.


Thrombocytopenia in older individuals is a common but diagnostically challenging condition that has variable clinical impact to those who are affected. Diagnostic approach requires evaluation of the preexisting clinical conditions, detailed review of medications, and assessment for disorders that warrant urgent treatment. In this article, we describe a systematic approach to diagnosis of thrombocytopenia and present a schematic review for management strategies. Three clinical scenarios are presented that are relevant for their prevalence and management challenges in an older adult population. The first scenario addresses primary immune thrombocytopenia (ITP) and reviews different treatment options. The second one addresses complications of thrombocytopenia in management of the myelodysplastic syndrome. The last one reviews diagnostic challenges of drug-induced ITP.

MeSH terms

  • Aged
  • Humans
  • Myelodysplastic Syndromes* / complications
  • Myelodysplastic Syndromes* / diagnosis
  • Myelodysplastic Syndromes* / therapy
  • Purpura, Thrombocytopenic, Idiopathic* / complications
  • Purpura, Thrombocytopenic, Idiopathic* / diagnosis
  • Purpura, Thrombocytopenic, Idiopathic* / therapy
  • Thrombocytopenia* / chemically induced
  • Thrombocytopenia* / diagnosis
  • Thrombocytopenia* / therapy