Bone marrow failure

Bone marrow failure occurs in individuals who produce an insufficient amount of red blood cells, white blood cells or platelets. Red blood cells determine how much oxygen needs to be distributed throughout the body’s tissue. White blood cells are constantly helping fight off germs and infections that enter the body. Bone marrow contains platelets, which clot then helps stop the blood flow when a wound occurs.^[1]

History

The cause of bone marrow failure is associated with three types of diseases, fanconi anemia (FA), dyskeratosis congenita, and aplastic anemia. Fanconi anemia is an inherited blood disorder due to abnormal breakouts in DNA genes. It is linked to hyperpigmentation, which is the darkening of an area of skin or nails caused by increased melanin. According to Histopathology, “However, in about 30% of FA patients no physical abnormalities are found”.^[2] Dyskeratosis congenita often affects multiple parts of the body. Individuals with this disorder usually show changes in skin pigmentations, unusual fingernail growth, and mucosa leukoplakia; the inner part of the mouth is encased with white patches that tend to never go away.^[2] Aplastic anemia happens when bone marrow doesn’t produce enough new blood cells throughout the body. Aplastic anemia is an acquired autoimmune disease, which occurs when the immune system mistakenly attacks and destroys healthy body tissue.^[3]

Causes

Bone marrow failure in both children and adults can be either inherited or acquired. Inherited bone marrow failure is often the cause in children while older children acquire the disease at an older age.^[1] A maturation defect in genes is a common cause of inherited bone marrow failure.^[4] “Genes are little pieces of information that tell the body what to do or what to make”.^[1] Acquired bone marrow failure is found more in adults later on in life. “The most common cause of acquired bone marrow failure is aplastic anemia”.^[4] People who work with chemicals such as benzene, which is derived from coal and petroleum and found in gasoline and other fuels, could be a factor in causing the illness. Other factors include radiation or chemotherapy treatments and immune system problems.

Signs and symptoms

The two most common signs and symptoms of bone marrow failure are bleeding and bruising. Blood may be seen throughout the gums, nose or the skin, and tend to last longer than normal. Children have a bigger chance of seeing blood in their urine or stools, which results in digestive problems with an unpleasant scent. Individuals with this condition may also encounter tooth loss or tooth decay. Feeling tired the majority of the time, shortness of breath, and colds that keep coming back are vital symptoms of bone marrow failure.^[5]

Treatment

The type of treatment depends on the severity of the patient’s bone marrow failure disease. Losing too much blood results in a blood transfusion. A blood transfusion replaces lost blood from the disease and gives the patient whole blood. Blood goes through a tube and ends up in a bag that is hooked to an intravenous catheter, which is then inserted into a vein. Blood transfusions are safe and acquiring a disease through a blood transfusion is rare. However, According to WebMD, “Getting the wrong blood type by accident is the main risk in a blood transfusion, but it is rare”.^[6] Blood is collected from volunteer donors who agree to let doctors draw blood stem cells from their blood or bone marrow for transplantation. “Blood stem cells are the cells that make all of the body’s blood cells”.^[7] Blood that is taken straight from collected blood stem cells is known as peripheral blood stem cell donation. A peripheral stem cell donor has the same blood type as the patient receiving the blood cells. Once the stem cells are in the patient’s body through an IV, the cells mature and become blood cells. Before donation, medicine is injected into the donor, which increases the number of stem cells into their body. Feeling cold and lightheaded, having numbness around the mouth and cramping in the hands are common symptoms during the donation process. After the donation, the amount of time for recovery varies for every donor, “But most stem cell donors are able to return to their usual activities within a few days to a week after donation”.^[7]

References