The bone marrow is an essential tissue of your body that performs many important functions. Production of red blood cells (RBC), white blood cells, and platelets is a process unique to the bone marrow. An abnormality in the functions of this spongy tissue, such as myelosuppression, can lead to diseases and disorders of the human body.
What is Myelosuppression?
Myelosuppression, commonly known as bone marrow suppression a condition characterized by the decrease in the production of blood cells due to reduced bone marrow activity.
A medical condition marked by the decrease in the production of red blood cells, white blood cells, and platelets. The condition can arise as a result of chemotherapy, tumors, or other reasons.
A severe form of the disease is known as myeloablation and can be potentially life-threatening to the patient. In such a condition, no blood cells are produced by the bone marrow.
Bone Marrow and Production of Blood Cells
Let’s talk about bone marrow and the process of hematopoiesis to grasp a better understanding of myelosuppression. The term, Hematopoiesis is a process through which cellular components of the blood are produced.
Hematopoietic stem cells are found in your bone marrow and can differentiate into red blood cells, white blood cells, or platelets through hematopoiesis. These blood cells further differentiate into specialized cells such as the several types of white blood cells.
In a person suffering from myelosuppression, the activity of these hematopoietic stem cells in the bone marrow is reduced. Indeed, This suppressed activity decreases the number of red blood cells, white blood cells, and platelets being produced.
Symptoms of Myelosuppression
In the final analysis, symptoms experienced by the patients of myelosuppression depend on the type of blood cell being affected, and the extent of deficiency of the blood cells.
Symptoms of decreased red blood cell production include:
- Lightheadedness
- Headache
- Weakness
- Fatigue
- Rapid heart rate
- In addition, The coldness of the hands and feet
- Shortness of breath
- Paleness of skin
- Hence, Paleness of the nail beds
As a result, Low white blood cell count increases the possibility of contracting infections. Some major symptoms include:
- Fever
- Chills
- Coughing
- Rashes or redness around sores or wounds
- Swelling
- Diarrhea
- Pain while passing urine
Symptoms of low platelet count include:
- Fatigue and weakness
- Nose bleeds
- Bleeding from gums
- Bruising easily
- Cuts and injuries do not clot and keep bleeding
- Furthermore, Passing blood in the urine
- Passing blood in the stool
- Heavy menstruation
Myelosuppression and Blood Cells
Consequently, Myelosuppression can affect the production of different types of blood cells or affect all blood cell production by suppressing bone marrow activity. Conditions associated with different blood cells are:
Red Blood Cells and Anemia:
Red blood cell’s most important function is to carry oxygen to different tissues of the body. RBC contain the protein hemoglobin which gives them the ability to carry oxygen. Oxygen is supplied to the tissues and organs of your body in exchange for carbon dioxide, which is then expelled from the body by the lungs.
Anemia a medical condition characterized by the deficiency of oxygen-carrying red blood cells. In this condition, an adequate amount of oxygen not supplied to the tissues and organs. In extreme cases when the condition goes untreated, tissue death can occur.
White Blood Cells and Leukopenia
White blood cells, also known as leukocytes form 1% of your blood. These blood cells are part of the immune system and help the body fight against invading antigens (foreign particles that elicit an immune response). These cells fight off bacteria and other microorganisms that cause infections and diseases.
White blood cells are further differentiated into more specialized cells, each having a very specific function related to your immunity. Types of white blood cells are monocytes, lymphocytes, neutrophils, basophils, and eosinophils.
The deficiency of white blood cells known as leukopenia. The type of leukopenia that a patient has depends on the type of white blood cells that is deficient. A decrease in the neutrophil count will lead to neutropenia, while a decrease in lymphocytes will lead to lymphopenia.
Platelets and Thrombocytopenia
Platelets specialized blood cells that form clots on site of injuries to stop the bleeding.
Thrombocytopenia is a condition in which your platelet levels decrease. Normal platelet count per microliter of blood ranges from 150,000 to 450,000. If the platelet count is lower than this, you have thrombocytopenia.
Patients with thrombocytopenia have trouble forming clots on the site of an injury and keep bleeding. The condition can be mild, moderate, or severe.
Pancytopenia
Pancytopenia characterized by the decrease in the production of all three types of blood cells i.e. red blood cells, white blood cells, and platelets.
Causes of Myelosuppression
Many factors that can cause the suppression of bone marrow activity and deficiency of blood cells. Causes of myelosuppression include:
Cancer
Replacement of healthy bone marrow by blood cancers or metastatic cancers can reduce the production of blood cells in the body.
Cancer of the bone marrow such as leukemia or myeloma can overcrowd the bone marrow, leaving no place for healthy hematopoietic cells to undergo hematopoiesis.
Medication
Medications used for chemotherapy damage stem cells and destroy their ability to multiply and replenish the blood cells of the body. Chemotherapeutic drugs administered through IV bolus knew to cause myelosuppression than drugs administered through IV infusion.
Common drugs used for chemotherapy that may cause myelosuppression include fluorouracil, oxaliplatin, irinotecan, and capecitabine. These drugs target rapidly dividing cells and kill them.
Myelosuppression stemming from medication use may temporary and the patient can recover once the drug is discontinued.
Bone Marrow Failure Syndromes
Bone marrow failure syndromes acquired or inherited disorders of the hemopoietic stem cells. In which the bone marrow unable to produce sufficient healthy blood cells.
Viruses
In case, Certain viruses attack the bone marrow and cause aplastic anemia. Viruses that may cause myelosuppression include HIV, parvovirus B19, Epstein-Barr, and cytomegalovirus.
Nutritional Deficiencies
Unless The deficiency of certain nutrients can cause myelosuppression. Some of these nutrients include folic acid, vitamin B-12, iron, and calcium.
Myelofibrosis
Scar tissues (fibrosis) that replaces bone marrow is another cause for myelosuppression. Since that area no longer contains healthy bone marrow, it can no longer produce blood cells.
Are Myelosuppression and Immunosuppression the Same Thing?
Myelosuppression and immunosuppression are not the same terms and cannot be used interchangeably. Myelosuppression may cause a decrease in white blood cell production (leukopenia). Since white blood cells from the immune system of our body, myelosuppression can lead to immunosuppression.
However, this does not mean that myelosuppression is the only cause of immunosuppression. Other factors, independent of myelosuppression can cause immunosuppression in patients, for example, certain medications.
Diagnosis and Treatment of Myelosuppression
Your doctor may conduct a physical exam and ask for your family history. Your blood samples will be taken and sent to a lab for analysis. The lab analysis compromises of a complete blood cell count.
In cases such as chemotherapy, the doctor can easily identify chemotherapy-induced myelosuppression.
The treatment plan for myelosuppression depends on the underlying condition causing the condition, the extent of the condition, and the type of the myelosuppression.
If you develop mild myelosuppression during chemotherapy, in most cases treatment is not necessary and blood cell count returns to normal within a few weeks. However, in severe cases, chemotherapy may stop to increase the body’s blood cell count.
In the case of bone marrow failure, your doctor may recommend a bone marrow transplant or transfusion to increase the production of healthy blood cells.
The doctor may also recommend the use of supplements or growth factor injections depending on the type of myelosuppression. The injections are given to targeted areas of the body and enhance bone marrow activity in that area.
Outlook
Sometimes myelosuppression can be prevented by changing lifestyle habits and maintain a balanced nutritional diet. While in other cases, no treatment required and the condition normalizes on its own or after the discontinuation of a certain medication.
However, severe cases of myelosuppression can be fatal if not treated properly in time. If you experience any of the above-stated symptoms, schedule an appointment with your primary healthcare physician.