Thrombocytopenia Platelet Threshold — MFDS Part 1 MCQ

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ModerateHuman DiseaseThrombocytopenia Platelet ThresholdMFDS Part 1

An adult receiving myelosuppressive cancer therapy requires a planned surgical dental extraction. A full blood count obtained within 24–48 hours shows isolated thrombocytopenia, and all other coagulation parameters are normal. Below which platelet count should the dental team liaise with the oncology or haematology team about the timing and extent of treatment and the possible need for haematological support?

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Correct answer: D — 50 × 10^9/L

The correct answer is D: 50 × 10^9/L. Current UK Faculty of Dental Surgery guidance advises liaison with the oncology or haematology team when the platelet count is 30–50 × 10^9/L, including discussion of treatment timing, procedural extent and any need for haematological support. Local haemostatic measures should be used. A count below 30 × 10^9/L prompts more specific discussion about platelet transfusion before invasive treatment, so option E is not the threshold at which liaison first becomes indicated. Counts of 80 or 100 × 10^9/L are unnecessarily high thresholds for this dental context, while waiting until 20 × 10^9/L would expose the patient to avoidable bleeding risk. The 50 × 10^9/L threshold is a management trigger, not an absolute biological boundary between safe and unsafe treatment.

Reference: Faculty of Dental Surgery, Royal College of Surgeons of England. The Oral & Dental Management of Patients Before, During and After Cancer Therapy, Table 4: Haematological Considerations for Invasive Dental Procedures. February 2026. https://www.rcseng.ac.uk/-/media/Files/RCS/FDS/Publications/The-oral-and-dental-management-of-patients-before-during-and-after-cancer-therapy.pdf