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Know About Bone Marrow Failure and Its Treatment

Bone marrow is full of a matrix of sinusoids filled with epithelial cells interspersed with reticulin-encapsulated islands of erythropoietic cells. The bone marrow consists of red marrow and inactive adipose tissue (yellow marrow) in about the same quantity. The bone marrow is located mainly in the pelvis, ribs, and ends of the axial skeleton’s long bones. At conception, 100% of the marrow is of the active red type, which is slowly replaced as an individual age by adipose tissue.

Before talking about the treatment, you need to know what bone marrow failure is. Bone marrow failure (BMF) refers to reduced development of one or more hematopoietic lineages resulting in diminished or absence of hematopoietic precursors in the bone marrow and associated cytopenias. It can be broken down into two categories: acquired and hereditary.

Inherited bone marrow failure (IBMF) is a defect of the bone marrow caused by germline mutations passed down from parents or resulting from de novo. Besides symptoms associated with aplastic anaemia such as weakness, haemorrhage, and recurrent bacterial infections, patients also have unique features of extra-marrow for each syndrome.

Causes

Causes of inherited bone marrow failure are.

  • Fanconi’s anaemia.
  • Diamond-Blackfan anaemia.
  • Dyskeratosis congenita.
  • Shwachman-Diamond syndrome.
  • Congenital amegakaryocytic thrombocytopenia.
  • Reticular dysgenesis.

Causes of acquired Bone marrow failure are,

  • Autoimmunity (as with aplastic anaemia in most cases)
  • Antineoplastic agents (chemotherapy), and other pharmacological agents (e.g., hormones, NSAIDs, allopurinol, anti-thyroid medications, chloramphenicol, gold) and poisons (e.g., benzene).
  • Malignancy causing invasion of the bone marrow-e.g., lymphoma, multiple myeloma, carcinoma, leukaemia in hairy cells.
  • Ionising radiation (including therapeutic radiotherapy).
  • Viruses (hepatitis B virus, Epstein-Barr virus, parvovirus B19).
  • Paroxysmal nocturnal haemoglobinuria (PNH).
  • Vitamin B12 or folate deficiency is causing maturation defects of the cells.

How to treat bone marrow failure?

Before deciding on which treatment to opt, one should completely know about bone marrow failure and how is it treated, and which is the better treatment based on their condition. Form of therapy is dependent on the extent of bone marrow failure disease in the patient. One remedy is blood transfusion. Blood is obtained from registered donors who decide to allow doctors to remove stem cells from their blood or bone marrow to be transplanted. Blood derived straight from harvested stem cells in the blood is called peripheral donation of stem cells in the blood. A peripheral source of stem cells must be of the same form of blood as the patient receiving the blood cells. When the stem cells are via an IV in the patient’s body, the cells grow and turn into blood cells. Medicine is inserted into the donor before donation, which increases the number of stem cells within their body. Feeling cold and lightheaded, getting numbness around the mouth and cramping in the hands during the donation process are typical symptoms.

The bone marrow surgery cost in India is high, so after the surgery, one should always be vigilant, because there is a high risk of rejection. It’s important to stick by what doctors say after the surgery and take care of the body.

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