{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:35:11Z","timestamp":1787841311442,"version":"build-2784847793"},"reference-count":7,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2023,1,1]],"date-time":"2023-01-01T00:00:00Z","timestamp":1672531200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2021,2,5]],"date-time":"2021-02-05T00:00:00Z","timestamp":1612483200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,1]]},"abstract":"\n Background:<\/jats:title>\n Thrombocytopenia is a frequently encountered laboratory abnormality and a common reason for hematology referrals. Workup for thrombocytopenia is not standardized and frequently does not follow an evidence-based algorithm. We conducted a systematic analysis to evaluate the laboratory testing and outcomes of patients evaluated for thrombocytopenia at hematology clinics in a tertiary referral center between 2013 and 2016.<\/jats:p>\n <\/jats:sec>\n \n Patient and methods:<\/jats:title>\n We performed a comprehensive chart review for patients evaluated for thrombocytopenia during the study period. Patients were followed for 1 year from the initial hematology evaluation and assessed for the development of a hematologic malignancy, rheumatologic, or infectious diseases among other clinical outcomes.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n We evaluated 472 patients with a median (range) age of 61 (17\u201394) years. The majority (63.8%) had mild thrombocytopenia. Within 1 year of follow-up, 14 patients (3.0%) were diagnosed with a hematologic malignancy. A higher likelihood of developing a hematologic malignancy was noted in patients with concurrent leukopenia (hazard ratio [HR] 9.97, 95% confidence interval [CI] 3.28\u201330.32, p < .01) and increasing age (HR per 10-year deciles 1.52, 95% CI 1.03\u20132.25, p = .03). In patients with asymptomatic isolated mild thrombocytopenia, laboratory testing did not reveal any significant positive findings and patients did not receive any new major diagnosis during the follow-up period.<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Our findings provide basis and call for development of an evidence-based algorithmic approach for evaluation of patients with thrombocytopenia, testing, and referrals. It also supports a conservative approach mainly driven by physical exam signs, symptoms, and other laboratory findings for patients with isolated mild thrombocytopenia.<\/jats:p>\n <\/jats:sec>","DOI":"10.1016\/j.hemonc.2021.01.002","type":"journal-article","created":{"date-parts":[[2021,2,10]],"date-time":"2021-02-10T20:43:35Z","timestamp":1612989815000},"page":"35-41","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Outcomes of Patients with Thrombocytopenia Evaluated at Hematology Subspecialty Clinics"],"prefix":"10.4103","volume":"16","author":[{"given":"Zaid H. Abdel","family":"Rahman","sequence":"first","affiliation":[{"name":"Division of Hematology and Medical Oncology, Mayo Clinic, Jacksonville, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin C.","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Medicine, Massachusetts General Hospital, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiba","family":"Jabbour","sequence":"additional","affiliation":[{"name":"Division of Hematology and Medical Oncology, Henry Ford Hospital, Detroit, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaser","family":"Alkhatib","sequence":"additional","affiliation":[{"name":"Division of Hematology and Medical Oncology, Henry Ford Hospital, Detroit, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijaya","family":"Donthireddy","sequence":"additional","affiliation":[{"name":"Division of Hematology and Medical Oncology, Henry Ford Hospital, Detroit, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,1,12]]},"reference":[{"key":"R1-20241211","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1055\/s-0037-1613840","article-title":"A novel approach to the assessment of variations in the human platelet count","volume":"83","author":"Buckley","year":"2000","journal-title":"Thromb Haemost"},{"key":"R2-20241211","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1002\/ajh.23172","article-title":"Referrals for suspected hematologic malignancy: a survey of primary care physicians","volume":"87","author":"Abel","year":"2012","journal-title":"Am J Hematol"},{"key":"R3-20241211","doi-asserted-by":"crossref","first-page":"4126","DOI":"10.1182\/blood-2009-01-200907","article-title":"Referral of patients with thrombocytopenia from primary care clinicians to hematologists","volume":"113","author":"Terrell","year":"2009","journal-title":"Blood"},{"key":"R4-20241211","doi-asserted-by":"crossref","first-page":"2127","DOI":"10.1182\/blood-2010-03-276691","article-title":"Identifying drugs that cause acute thrombocytopenia: an analysis using 3 distinct methods","volume":"116","author":"Reese","year":"2010","journal-title":"Blood"},{"key":"R5-20241211","doi-asserted-by":"crossref","first-page":"886","DOI":"10.7326\/0003-4819-129-11_Part_1-199812010-00009","article-title":"Drug-induced thrombocytopenia: a systematic review of published case reports","volume":"129","author":"George","year":"1998","journal-title":"Ann Intern Med"},{"key":"R6-20241211","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/j.tmrv.2013.05.005","article-title":"Approach to the diagnosis and management of drug-induced immune thrombocytopenia","volume":"27","author":"Arnold","year":"2013","journal-title":"Transfus Med Rev"},{"key":"R8-20241211","first-page":"1","article-title":"Recommendations for the identification of chronic hepatitis C virus infection among persons born during 1945\u20131965","volume":"61","author":"Smith","year":"2012","journal-title":"MMWR Recomm Rep"}],"container-title":["Hematology\/Oncology and Stem Cell Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1658387621000029?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1658387621000029?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ovid.com\/10.1016\/j.hemonc.2021.01.002","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:48:30Z","timestamp":1787838510000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1016\/j.hemonc.2021.01.002"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1]]},"references-count":7,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.1016\/j.hemonc.2021.01.002","relation":{},"ISSN":["1658-3876","2589-0646"],"issn-type":[{"value":"1658-3876","type":"print"},{"value":"2589-0646","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1]]},"assertion":[{"value":"2020-10-06","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-01-15","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}