IL6 and neoplasm: Interestingly, the size of platelets is reduced in patients with solid tumors and skeletal metastasis.(32) Although the mechanism underlying this observation is obscure, it is known that platelet size is determined at the MK stage and is inversely proportional to MK ploidy.(33) MK ploidy is regulated by cytokines such as IL-3 and IL-6, which contribute to more reactive and larger platelets.(33,34) Identifying the interaction between tumor cells and MKs could result in a better understanding of the decrease in platelet size in patients with skeletal metastasis.