Gemcitabine: Association with Thrombocytosis

Gemcitabine is a pyrimidine antimetabolite that affects DNA synthesis in the S-phase of the cell cycle. It is effective against cancers such as ovarian carcinoma, non-small cell lung cancer, and pancreatic cancer. However it causes significant side effects like myelosuppression, which leads to thrombocytopenia in about 71% of patients, prompting discontinuation of therapy. Even though thrombocytopenia is common, some patients experience thrombocytosis during Gemcitabine therapy, especially in the second and third cycles, possibly due to a rebound effect. Thrombocytosis is usually asymptomatic and occasionally leads to venous thrombosis, but its clinical significance is uncertain because of conflicting studies. Further research is required to understand the physiology behind thrombocytosis in Gemcitabine-treated patients. Fluctuations between thrombocytosis and thrombocytopenia need to be closely monitored. Management for Gemcitabine-induced thrombocytosis can be improved if more comprehensive studies are undertaken to explore the role of thrombocytosis in cardiovascular events.