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Bone marrow suppression also known as myelotoxicity or myelosuppression, is the decrease in production of cells responsible for providing immunity , carrying oxygen (erythrocytes), and/or those responsible for normal blood clotting (thrombocytes). [1]
Myeloid-derived suppressor cells (MDSC) are a heterogeneous group of immune cells from the myeloid lineage (a family of cells that originate from bone marrow stem cells). MDSCs expand under pathologic conditions such as chronic infection and cancer, as a result of altered haematopoiesis . [ 1 ]
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Pancytopenia usually requires a bone marrow biopsy in order to distinguish among different causes. [5] anemia: hemoglobin < 13.5 g/dL (male) or < 12 g/dL (female). leukopenia: total white cell count < 4.0 x 10 9 /L. Decrease in all types of white blood cells (revealed by doing a differential count). thrombocytopenia: platelet count < 150×10 9 /L.
Common side effects include bone-marrow suppression and vomiting. [5] Bone-marrow suppression is especially common in people with a genetic deficiency of the enzyme thiopurine S-methyltransferase. [5] Other serious risk factors include an increased risk of certain cancers. [5] Use during pregnancy may result in harm to the baby. [5]
Bone marrow is a semi-solid tissue found within the spongy (also known as cancellous) portions of bones. [2] In birds and mammals, bone marrow is the primary site of new blood cell production (or haematopoiesis). [3] It is composed of hematopoietic cells, marrow adipose tissue, and supportive stromal cells.
Other causes of reactive thrombocythemia include: post surgery, iron deficiency, drugs, and rebound effect after bone marrow suppression. [8] Research suggests that thrombocytosis can also occur after physical exercise, and is triggered by hemoconcentration and the release of platelets from the liver, lungs and spleen. [3] [9]
Further, immune suppressive medications are usually unnecessary if CD6+ T cells are removed from the donor marrow. [ 32 ] Patients can relapse even after a TCD allogeneic bone marrow transplant, though patients with chronic myelogenous leukemia (CML) who receive a donor lymphocyte infusion (DLI) can restore complete remission.