Bone Marrow Disorders

Bone marrow is a soft, spongy tissue that is present in the hollow spaces in the interior of the bones, such as the hip and thigh bones. Bone marrow contains stem cells which in turn develop into red blood cells, white blood cells and platelets. A disease in the bone marrow may disturb the stem cell production which causes abnormality in the mature blood cells. Genetic or environmental factors, infection may all contribute to bone marrow disorders.

Types of bone marrow disorders

• Chronic myelogenous leukemia: It is a disease which produces too many white blood cells in the bone marrow.
• Polycythemia Vera: It is a rare blood disease which is caused due to the over production of red blood cells and thus blocks the flow of blood in the arteries and veins.
• Myelodysplastic syndrome (MDS): It is a disease in which the bone marrow does not produce enough healthy blood cells.
• Aplastic anemia: It is a bone marrow disease that does not produce enough new red blood cells.

Signs and symptoms

• Fatigue
• Fever
• Unexplained weight loss
• Muscle weakness
• Bruising
• Poor healing
• Shortness of breath

Diagnosis

• Complete blood count is done to determine the number, size, shape and types of blood cells. It helps in checking the health status of the individual. In this test, a small amount of blood is drawn from a vein in the arm of the patient and is sent to the laboratory. The test results help in diagnosing the type of bone marrow disorder.

The normal blood count test results for adults:

• Blood smear is performed to assess the changes in the morphology of the blood cells. The blood smear is stained and viewed under the microscope to detect the changes and abnormalities in the blood cells.
• Bone marrow aspiration and biopsy is a method used to evaluate the blood cells present within the bone marrow. Bone marrow aspiration is usually performed along with a biopsy of the bone marrow. In this procedure the patient is first given local anesthesia to numb the area and a hollow needle is used to remove a small sample of the soft tissue present inside the bone marrow. The needle is inserted into the hip region in adults and into the upper part of the larger bone (tibia) in children. The fluid portion of the bone marrow is drawn out and the sample is sent to the laboratory for testing. The test results help in determining the type and stage of the bone marrow disorder.
• Karyotyping is performed to detect the chromosome abnormalities
• Immunophenotyping is performed to diagnose leukemia or lymphoma
• Imaging tests such as MRI, CT scan and X-ray help in detecting the spread of the disease to various other parts of the body.

Treatment

• Folic acid supplements
• Chemotherapy
• Radiation therapy
• Blood transfusion
• Platelet transfusion
• Bone marrow transplantation

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References