Bone marrow suppression: Difference between revisions

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Revision as of 20:23, 16 February 2015

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and keywords: Bone marrow failure, bone marrow depression, myelosuppression, myelosuppressive disorder

Overview

Bone marrow suppression is a serious side effect of chemotherapy and certain drugs affecting the immune system such as azathioprine. NSAIDS may also cause bone marrow suppression. The risk is especially high in chemotherapy for leukaemia.

The bone marrow is where blood cells are formed, and this process is slowed or stopped when bone marrow suppression is caused. This can rapidly lead to life-threatening infection as the body cannot produce leukocytes in response to invading bacteria and viruses, as well as anaemia due to a lack of red blood cells and spontaneous severe bleeding due to deficiency of platelets.

Bone marrow suppression due to azathioprine can be treated by changing to another medication such as mycophenolate mofetil (for organ transplants) or other disease-modifying drugs in rheumatoid arthritis or Crohn's disease. Bone marrow suppression due to anti-cancer chemotherapy is much harder to treat and often involves hospital admission, strict infection control, and aggressive use of intravenous antibiotics at the first sign of infection.

Classification

Myelodysplasia

All hematopoietic lineages

Aplastic anemia (aplastic pancytopenia)

Paroxysmal nocturnal hemoglobinuria (PNH)

Myelosuppression

Pure red cell aplasia (erythroblastopenia)

One lineage

Neutropenia (granulocytopenia and agranulocytosis)

Acquired bone marrow suppression

Amegakaryocytic thrombocytopenia

T-cell immunosuppression

Immunosuppression

B-cell immunosuppression

Bone Marrow Suppression

NK cell immunosuppression

Multiple lineages

Congenital bone marrow suppression

One lineage

Causes

Drug Side Effects

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