Three weeks ago, my mother was admitted to ER with critically low platelets and hemoglobin. Her hemoglobin has been above 7 g/dL for a week, but her platelet levels have not raised despite daily transfusions (even with HLA cross-matching). Two hours post-transfusion her platelet levels increase, however, they are decreasing by the next day. Bone marrow biopsy is not feasible for her condition.
She has metastatic BRCA-positive ovarian cancer and has had several rounds of chemotherapy and radiation. Two weeks prior to hospital admission, she had started keytruda single-agent immunotherapy and also got had a small brain lesion treated with radiotherapy in the same week. Doctors suspect there can be chemotherapy or radiotherapy-induced bone marrow damage or disease infiltration of the marrow. However, there is no reason to prove stable RBSs and WBCs and low platelet count.