Myelosuppression
- Description. Myelosuppression is a decrease in the production of blood cells. ...
- Causes. The most common cause of myelosuppression is cancer treatment. Many of the drugs used in chemotherapy temporarily suppress the bone marrow.
- Treatments. Myelosuppression is not always treated, especially if it is mild. ...
What is myelosuppression?
Myelosuppression, or bone marrow suppression, is defined as a decrease in the ability of the bone marrow to produce blood cells. This may result in a lack of red blood cells (anemia), white blood cells (leukopenia), and platelets (thrombocytopenia). Myelosuppression may occur when the stem cells in the bone marrow are damaged (such as by ...
Can cancer cause myelosuppression?
Cancer cells can also cause myelosuppression. Some cancers invade the bone marrow and crowd out the cells normally found there. Others can suppress the bone marrow without invasion. Nutritional deficiencies, common in cancer patients, also slow blood cell production as do viruses and some non chemo drugs.
What are the treatment options for multiple myelosuppression?
The treatment of myelosuppression will involve treating whatever the cause of myelosuppression happens to be. If it is related to drugs or chemotherapy, treatments may have to be stopped or delayed. If it is due to infiltration of the bone marrow, and consequent crowding, treatment of the cancer in the bone marrow is the most important step.
What cells are affected by myelosuppression?
Cells Affected in Myelosuppression. Myelosuppression can result in decreased production of: Red blood cells (RBCs): Red blood cells contain hemoglobin, the protein that is responsible for binding with and delivering oxygen to all of the tissues of the body.
What happens in myelosuppression?
Myelosuppression — also referred to as bone marrow suppression — is a decrease in bone marrow activity resulting in reduced production of blood cells. This condition is a common side effect of chemotherapy. It can range from mild to severe. Severe myelosuppression, called myeloablation, can be fatal.
What is the cause of myelosuppression?
Myelosuppression may occur when the stem cells in the bone marrow are damaged (such as by chemotherapy drugs), when it is crowded (by tumor cells or fibrosis), or due to bone marrow failure.
What is the difference between myelosuppression and bone marrow suppression?
Myelosuppression, also known as bone marrow suppression, is a decrease in bone marrow activity that results in reduced production of blood cells. Some blood cell disorders include: fewer red blood cells (anemia)
What are myelosuppressive drugs?
Myelosuppressive therapies, such as chemotherapy and radiation therapy, kill normal cells and cancer cells in the bone marrow. This lowers the number of normal red blood cells, white blood cells, and platelets in the blood and bone marrow.
What is myelosuppression and symptoms?
Listen to pronunciation. (MY-eh-loh-suh-PREH-shun) A condition in which bone marrow activity is decreased, resulting in fewer red blood cells, white blood cells, and platelets. Myelosuppression is a side effect of some cancer treatments.
Which drugs cause bone marrow suppression?
Other chemicals/drugs known to cause bone marrow suppression include chloramphenicol, meclofenamic acid, phenylbutazone, quinidine, trimethoprim-sulfadiazine, albendazole and fenbendazole (Manyan et al., 1972).
What drugs can cause myelosuppression?
Fluorouracil: This drug can cause all forms of myelosuppression. Oxaliplatin: This medication can cause neutropenia and thrombocytopenia. Irinotecan: This agent can lead to neutropenia. Capecitabine: This medication can cause all forms of myelosuppression.
What is meant by myelosuppression?
Myelosuppression is a condition in which bone marrow activity is decreased, resulting in fewer red blood cells, white blood cells, and platelets. It is a side effect of some cancer treatments. Also called myeloablation.
Which cells are affected by myelosuppression?
Myelosuppression, sometimes called bone marrow suppression, is a common side effect of chemotherapy that is characterized by a decrease in blood cell production. Three different kinds of blood cells are produced in the body's bone marrow – red blood cells, white blood cells and platelets.
How do you manage myelosuppression?
The three components of myelosuppression management are: prevention of infection, frequent patient assessment for the early detection of infection, and aggressive management when such infection arises.
How can I prevent myelosuppression?
Rock-a-bye bone marrow discovered that quizartinib, a tyrosine kinase inhibitor, can decrease the risk of myelosuppression during cancer treatment by transiently suppressing the proliferation of bone marrow progenitor cells.
What causes bone marrow to decrease?
In aplastic anemia, stem cells are damaged. As a result, the bone marrow is either empty (aplastic) or contains few blood cells (hypoplastic). The most common cause of aplastic anemia is from your immune system attacking the stem cells in your bone marrow.
What is meant by myelosuppression?
Myelosuppression is a condition in which bone marrow activity is decreased, resulting in fewer red blood cells, white blood cells, and platelets. It is a side effect of some cancer treatments. Also called myeloablation.
Which cells are affected by myelosuppression?
Myelosuppression, sometimes called bone marrow suppression, is a common side effect of chemotherapy that is characterized by a decrease in blood cell production. Three different kinds of blood cells are produced in the body's bone marrow – red blood cells, white blood cells and platelets.
What causes bone marrow to stop working?
Other causes of bone marrow failure are acquired. The most common forms occur from drugs, chemicals, radiation, viral infections, immune disorders, MDS, PNH, or large granular lymphocytic leukemia.
How can I prevent myelosuppression?
Rock-a-bye bone marrow discovered that quizartinib, a tyrosine kinase inhibitor, can decrease the risk of myelosuppression during cancer treatment by transiently suppressing the proliferation of bone marrow progenitor cells.
What is myelosuppression in a patient?
What is myelosuppression? Myelosuppression — also referred to as bone marrow suppression — is a decrease in bone marrow activity resulting in reduced production of blood cells.
What causes myelosuppression?
While this procedure is meant to destroy cancer cells, it can also affect your bone marrow and destroy your healthy blood cells. Other causes of myelosuppression include: medication that suppresses blood cells replenishment.
How long does it take for myelosuppression to go away?
Treating myelosuppression depends largely on the cause. If you’re in chemotherapy, your blood cell counts will begin to decrease between 7 to 10 days after starting treatment. In mild cases of myelosuppression, treatment is not necessary.
What is a decrease in all three blood cells called?
A decrease in all three types of blood cells is referred to as pancytopenia. This condition is life-threatening. It can cause an oxygen shortage and other immune issues.
Is myeloablation fatal?
Severe myelosuppression, called myeloablation, can be fatal. The body’s bone marrow produces three types of cells: white blood cells, red blood cells, and platelets. Myelosuppression can decrease some or all of these. A decrease in all three types of blood cells is referred to as pancytopenia. This condition is life-threatening.
How do you know if you have myelosuppression?
The signs of myelosuppression depend on which type of blood cells are in low supply. In some cases, it causes only mild symptoms. But it also can lead to serious problems and even be life-threatening. Symptoms of anemia include: Pale skin and lips. Pale nails. Fatigue. Feeling dizzy. Weakness.
What is bone marrow suppression?
It can also be a side effect of some cancer treatments, like radiation, chemotherapy drugs, and steroids. Bone marrow is the soft, spongy tissue in the middle of your bones. It's where red blood cells, white blood cells, and platelets are made. Each of those plays a different role in ...
Does myelosuppression affect cancer?
Myelosuppression can also make your cancer treatment take longer and affect your quality of life.
What is myelosuppression in medical terms?
myelosuppression (my-ĕ-loh-sŭ-presh-ŏn) n. a reduction in blood-cell production by the bone marrow. It commonly occurs after chemotherapy and may result in anaemia, infection, and abnormal bleeding (see thrombocytopenia, neutropenia ).#N#— myelosuppressive adj.
What causes myelosuppression?
Many of the drugs used in chemotherapy temporarily suppress the bone marrow. Therapeutic x rays that reach the bone marrow are also destructive. Cancer cells can also cause myelosuppression. Some cancers invade the bone marrow and crowd out the cells normally found there. Others can suppress the bone marrow without invasion. Nutritional deficiencies, common in cancer patients, also slow blood cell production as do viruses and some non chemo drugs.
How long does it take for myelosuppression to go away?
Myelosuppression usually starts seven to ten days after an injury to the bone marrow. However, the bone marrow generally returns to normal within the next few weeks. Less often, cumulative damage can be caused. Occasionally, irreversible damage causes permanent myelosuppression. Very intensive chemotherapy or radiation can destroy all of the cells in the bone marrow.
How to help myelosuppression?
Supportive therapy can help to minimize the effects of myelosuppression. If nutrition is a contributing factor, iron or vitamin supplements may be beneficial. Antibiotics can aid in preventing infections. Some patients find that mild exercise and enjoyable distractions help with fatigue.
Is myelosuppression a painless condition?
Myelosuppression is a painless condition, but the decreases in important blood cells can result in fatigue , an increased risk of infections, or excessive bleeding. The consequences vary from mild to life-threatening, depending on how low the blood cell numbers fall.
Is myelosuppression always treated?
Myelosuppression is not always treated, especially if it is mild.
Is myelosuppression a drug?
Drug-induced myelosuppression : diagnosis and management. Myelosuppression is a common and anticipated adverse effect of cytotoxic chemotherapy. It is a potential but rare idiosyncratic effect with any other drug, but there is a recognised association with a number of higher-risk agents which justify additional vigilance.
Is myelosuppression a genetic risk factor?
Genetic risk factors are being ide …. Myelosuppression is a common and anticipated adverse effect of cytotoxic chemotherapy. It is a potential but rare idiosyncratic effect with any other drug, but there is a recognised association with a number of higher-risk agents which justify additional vigilance. Genetic risk factors are being ide ….
Is myelosuppression life threatening?
Myelosuppression is potentially life threatening because of the infection and bleeding complications of neutropenia and thrombocytopenia. Strategies for monitoring, early detection, diagnostic confirmation and appropriate supportive care are well developed for cytotoxic therapy.
How long does it take for myelosuppression to show in dogs?
Myelosuppression in dogs is seen at 7 to 14 days and may be severe. Dogs and cats may experience delayed and cumulative neutropenia and thrombocytopenia, and dogs may also develop potentially fatal hepatotoxicity. 79–81,84 A retrospective study of 179 dogs treated with lomustine reported that 11 dogs (6.1%) experienced hepatic toxicity, and seven of these dogs died of progressive liver failure. 84 Greater numbers of treatments were more likely to be associated with hepatopathy. Liver enzymes, particularly alanine aminotransferase (ALT), should be monitored throughout lomustine therapy, and the drug should be discontinued if ALT elevation occurs.
Why is bone marrow suppressed?
Bone marrow suppression may result from direct damage to cell precursors as well as from alterations in the cytokine profile secondary to the drug. Suppression is a widely recognized side effect of chemotherapeutic/antineoplastic agents, primarily due to the high mitotic rate of this tissue.
What causes bone marrow suppression in dogs?
Bone marrow suppression may occur in association with infectious agents that can directly infect hematopoietic precursors such as immunodeficiency viruses in various species, parvoviruses, distemper virus in dogs, and feline leukemia virus in cats (Russell, 2010; Stockham and Scott, 2008c; Scaradavou, 2002 ). Chronic ehrlichiosis in dogs has also been reported to cause bone marrow hypoplasia, although the mechanism remains unclear ( Stockham and Scott, 2008c ). However, decreases in platelet counts attributable to infectious agents may have contributions from mechanisms other than bone marrow suppression, such as peripheral consumption or immune-mediated destruction. Hyperestrogenism associated with testicular or ovarian neoplasia may also cause general bone marrow suppression, and dogs appear to be particularly sensitive to this effect ( Sontas et al., 2009 ).
What enzyme is correlated with TPMT?
Sensitivity to the adverse effects, and prediction of therapeutic effects in people may be correlated with the levels of the metabolizing enzyme, thiopurine methyltransferase (TPMT). Some people are deficient and have a higher incidence of adverse effects.
What causes a decrease in platelet count?
Inherited or congenital forms cause marked decreases in blood platelet counts with an absence of megakaryocytes in the bone marrow. This form is frequently associated with mutations in the TPO receptor gene, MPL, and may progress to aplastic anemia ( Germeshausen et al., 2006; Van Den Oudenrijn et al., 2000 ).
Does chloramphenicol cause bone marrow suppression?
Bone marrow suppression occurs in all individuals who take chloramphenicol regularly. This is primarily manifested by a reversible fall in reticulocyte count. Depressions in platelet count may also occur. Dose-related bone marrow suppression is associated with serum concentrations ⩾25 μg ml −1. Chloramphenicol can also produce severe, idiosyncratic bone marrow toxicity resulting in aplastic anemia. This may occur more commonly in those who undergo prolonged therapy. The reported incidence of severe bone marrow toxicity ranges from 1:30000 to 1:100000. Greater myelotoxicity occurs in uremic patients. Other adverse effects include hypersensitivity reactions (including rash and fever), paresthesias, and optic neuritis. Chloramphenicol may also inhibit hepatic microsomal activity, specifically impairing the clearance of drugs including warfarin, phenytoin, and many other drugs.
When was Meyler's Side Effects of Drugs published?
In Meyler's Side Effects of Drugs: The International Encyclopedia of Adverse Drug Reactions and Interactions (Fifteenth Edition), 2006
What is immunosuppressive therapy?
Patients with autoimmune disease and patients who have received transplanted tissues or organs typically require therapy with immunosuppressive drugs. Immunosuppressive agents have been in use for more than 50 years, beginning with corticosteroids, antimetabolites, and alkylating agents. These early agents assisted in the treatment of previously incurable conditions, but their lack of specificity led to many serious adverse effects. Over the past 20 years, the field of immunosuppression has shifted to specific inhibitors of immunity that affect distinct immune pathways. This shift is important both because of the greater efficacy and reduced toxicity of these agents and because, as the mechanisms of these agents are discovered, insights are gained into the operation of the immune system.
What are cytotoxic agents used for?
Cytotoxic agents are used both for immunosuppression and for antineoplastic chemotherapy. The therapeutic goal in both cases is the elimination of pathogenic cells. Two classes of cytotoxic agents, antimetabolites and alkylating agents, are commonly used as immunosuppressants. Antimetabolites are structural analogues of natural metabolites that inhibit essential pathways involving these metabolites. Alkylating agents interfere with DNA replication and gene expression by alkylation of DNA.
Hematopoiesis, Bone Marrow, and Myelosuppression
Symptoms
- The symptoms of myelosuppression depend on the underlying cause, the level of deficiency of blood cells, and more. Low red blood cells counts can lead to fatigue, lightheadedness, weakness, pale skin and nail beds, a rapid heart rate, and shortness of breath. Since red blood cells carry oxygen in the blood to different parts of the body, a low number can also cause symptoms simil…
Causes
- There are several ways in which the bone marrow can be disrupted so that it does not produce blood cells, but these can be broken down into three major categories: 1. Damage to the stem cells 2. Crowding of the bone marrow 3. Bone marrow failure Regardless of the method, the result is that fewer blood cells are formed. Sometimes the cause of myelosuppression is very obvious…
Diagnosis
- The diagnosis of myelosuppression will depend on many factors. In the case of chemotherapy-induced myelosuppression, the cause is often obvious. In other cases, a careful history, physical exam, and imaging studies will likely be done, but laboratory analysis is often the mainstay of diagnosis. This usually begins with a complete blood count to look at the numbers of each type …
Treatment
- The treatment of myelosuppression including addressing the underlying cause(s), raising levels of blood cells when needed, and treating symptoms related to the deficiencies.
Coping and Prevention
- Sometimes low blood counts do not require treatment, yet there are still things you can do to increase your risk. These lifestyle measures are wise even if your low counts are being treated. For anemia: Getting slowly (to avoid fainting), pacing yourself throughout the day, do some light exercise every day, talk to your healthcare provider about coping with fatigue related to cancer o…