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Bone marrow examination is required to assess erythroid, myeloid and megakaryocytic precursors, identify genetic abnormalities, and rule out other entities such as leukemia. [11] B-cell lymphopenia has been observed in some patients with MECOM deficiency but is not a definitive indicator.
Normal bone marrow has 30–70% blood stem cells, but in aplastic anemia, these cells are mostly gone and are replaced by fat. [ 5 ] [ 6 ] First-line treatment for aplastic anemia consists of immunosuppressive drugs —typically either anti-lymphocyte globulin or anti-thymocyte globulin —combined with corticosteroids , chemotherapy , and ...
Indicators of a poor prognosis: Advanced age; severe neutropenia or thrombocytopenia; high blast count in the bone marrow (20–29%) or blasts in the blood; Auer rods; absence of ringed sideroblasts; abnormal localization or immature granulocyte precursors in bone marrow section; completely or mostly abnormal karyotypes, or complex marrow ...
Causes of decreased production include iron deficiency, folate deficiency, vitamin B 12 deficiency, thalassemia and a number of bone marrow tumors. [1] Causes of increased breakdown include genetic disorders such as sickle cell anemia , infections such as malaria , and certain autoimmune diseases like autoimmune hemolytic anemia .
Sideroblastic anemia, or sideroachrestic anemia, is a form of anemia in which the bone marrow produces ringed sideroblasts rather than healthy red blood cells (erythrocytes). [1] In sideroblastic anemia, the body has iron available but cannot incorporate it into hemoglobin , which red blood cells need in order to transport oxygen efficiently.
Vitamin B 12 deficiency, which is reversible, is occasionally confused with acute myeloid leukemia, which is an irreversible condition presenting with some of the same hematological symptoms, including hypercellular bone marrow with blastic differentiation and hypersegmented neutrophils. [32]
Pyruvate kinase deficiency is the second most common cause of enzyme-deficient hemolytic anemia, following G6PD deficiency. [13] The symptoms of pyruvate kinase deficiency are mild to severe hemolytic Anemia, cholecystolithiasis, tachycardia, hemochromatosis, icteric sclera, splenomegaly, leg ulcers, jaundice, fatigue, and shortness of breath. [14]
Iatrogenic causes of pancytopenia include chemotherapy for malignancies if the drug or drugs used cause bone marrow suppression. Rarely, drugs (antibiotics, blood pressure medication, heart medication) can cause pancytopenia. For example, the antibiotic chloramphenicol can cause pancytopenia in some individuals. [1]
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