Bone marrow suppression
As myelosuppression, even bone marrow ( s ) or bone marrow depression ( s ) inhibition [Footnote 1 ] called, is defined as the exposure of normal blood formation ( hematopoiesis ) in bone marrow. In the English literature one speaks of bone marrow suppression, myelotoxicity or myelosuppression.
Effects
By suppressing the formation of blood occurs in the organism to a lack
- Red blood cells ( anemia → )
- White blood cells ( leukopenia →, neutropenia),
- Platelets ( thrombocytopenia → ).
As a result of this deficiency, the immune system is significantly weakened, making it often can lead to infections, among others. The lack of platelets ( thrombocytes) leads to an increased risk of bleeding. The anemia leads among other things to a drop in performance and faster fatigue. Myelosuppression is potentially life threatening.
Causes
Myelosuppression can be triggered by all the factors that damage the bone marrow. This may be exogenous factors such as radiation therapy, radiation sickness and chemotherapy with cytotoxic drugs. Incompatibilities on drugs, for example, dipyrone, can lead to myelosuppression on agranulocytosis. Internal factors that can lead to myelosuppression include the Immune and Knochenmarkkarzinosen. Also cytomegalovirus can cause myelosuppression.
Almost all cytotoxic drugs are myelosuppressive and limit for many of these agents the dose.
While increasingly adjust resistance to the cytotoxic drugs in cancer cells during the therapy cycles, this is not the case with the blood-forming ( hematopoietic ) stem cells. Problem is exacerbated by the damage with each cycle of therapy.
Therapy
When chemotherapy can be mitigated or reduced by the concomitant administration of hematopoietic growth factors such as granulocyte- colony stimulating factor (G -CSF) acute myelosuppression. The conditional by chemotherapy damage to the bone marrow is almost always curable.
For the complete elimination of stem cells in the bone marrow is called an irreversible myeloablation. You may be therapeutically necessary in certain cases. Through a stem cell bone marrow can then be restored.
Further Reading
- L. Balducci: Myelosuppression and Its Consequences in elderly patients with cancer. In: Oncology (Williston Park, NY) Volume 17, Number 11 Suppl 11, November 2003, pp. 27-32, ISSN 0890-9091. PMID 14,682,116th (Review).
- MB Maxwell, KE Maher: Chemotherapy -induced myelosuppression. In: Seminars in oncology nursing Volume 8, Number 2, May 1992 pp. 113-123, ISSN 0749-2081. PMID 1621002nd (Review).
- SM Grant and RC Heel: Recombinant granulocyte - macrophage colony-stimulating factor ( rGM -CSF). A review of its pharmacological properties and prospective role in the management of myelosuppression. In: Drugs Volume 43, Number 4, April 1992, pp. 516-560, ISSN 0012-6667. PMID 1377118th (Review).