Is a platelet count of 8,000 per mcL in ITP dangerous?

Hi doctor,

My 38-year-old sister was diagnosed with chronic immune thrombocytopenic purpura (ITP) about six months ago, and we are extremely concerned about her condition worsening. Her platelet count recently dropped to 8,000, and she is covered in bruises from head to toe; even the lightest touch can cause visible marks. She frequently experiences severe nosebleeds that last for hours and are very difficult to control.

Just last week, she had some spotting between her periods, which quickly progressed into heavy bleeding. Her gums also bled every time she brushed her teeth. Her hematologist initially started her on Prednisone, which temporarily increased her platelet count. However, her levels are now dropping again, and the side effects from the steroids, such as significant weight gain, mood swings, and insomnia, are making her feel even worse.

She is terrified to go about her daily life because even simple, everyday activities feel risky. Shaving her legs or playing with her children now seems potentially dangerous due to the high risk of bleeding. Her doctor has discussed other treatment options, such as intravenous immunoglobulin (IVIG) or even splenectomy, but she is understandably anxious about undergoing surgery.

We are wondering: Are there any newer or less invasive medications currently available for treating chronic ITP? How dangerous is it when platelet counts fall this low, and what steps can we take to help her feel safer and more in control of her condition?

Please help me.

Thanks.