Anemia of bone marrow failure and systemic disorders Flashcards
is the reduction or cessation of blood cell production affecting one or more cell lines.
Bone marrow failure
decreased numbers of circulating RBC, WBC, and platelets.
Pancytopenia
Pathophysiology of Bone marrow failure
- Destruction of hematopoietic stem cells as a result of injury.
- premature senescence and apoptosis of hematopoietic stem cells as a result of genetic mutations.
- Ineffective hematopoiesis caused by stem cell mutations or Vitamin b12 or folate deficiency.
- Disruption of the bone marrow microenvironment that supports hematopoiesis.
- loss of hematopoietic tissue as a result of infiltration of the marrow space with abnormal cells.
a bone marrow failure syndrome resulting from damaged or defective stem cells
aplastic anemia
Who provided the first case report of aplastic anemia?
Ehrlich in 1888
Who gave the name aplastic anemia?
Vaquez and Aubertin in 1904
Characteristics of aplastic anemia
- Pancytopenia
- Reticulocytopenia
- Bone marrow hypocellularity
- Depletion of hematopoietic stem cells.
underdevelopment or incomplete development of a tissue or organ.
Hypoplasia
failure of a tissue to develop
aplasia
anemia with no known cause
idiopathic acquired aplastic anemia
anemia associated with an identified cause
secondary acquired aplastic anemia
Bone Marrrow if
less than 25% bone marrow cell or less than 50% normal cellularity with less than 30% hematopoetic cells
there are no immature myeloid cells in the peripheral blood.
aplastic anemia
is the classic drug associated with
marrow aplasia
Chloramphenicol
PRIMARY:
- Fanconi Anemia (Congenital)
- Inborn due to inheritance - Idiopathic aplastic anemia (Acquired)
- Unknown cause
Secondary
- Drugs
- Chemicals
- Radiation
- Immune mechanism
- Infections (Hepatitis C, viral diseases, millary tuberculosis, Brucellosis, Parasites
Caused either directly by lymphocytes or by some humoral factors
Immune Mechanisms
Rare, inherited form of aplastic anemia
Fanconi Anemia
A rare condition that involves either an idiopathic or an immune mechanism
ACQUIRED PURE RED CELL APLASIA
Some patients may have an Ig inhibitor of erythroid precursors or erythropoietin inhibitor
ACQUIRED PURE RED CELL APLASIA
A rare congenital disorder defined as a
normochromic- normocytic anemia with normal leukocyte and platelet count and a marked decrease in marrow normoblasts
DIAMOND BLACKFAN ANEMIA
A common finding in 94% of patients with carcinoma
MYELOPHTHISIC ANEMIA
is the presence of circulating nucleated rbc (NRBC) and immature leukocytes in the peripheral blood
LEUKOERYTHROBLASTIC REACTION
Aplastic anemias which have a number of identified causative factors and agents.
SECONDARY APLASTIC ANEMIAS
Seen in long term, low dose irradiation where radiation may damage the stem cells
Radiation
Caused either directly by lymphocytes or by some humoral factors
Immune Mechanisms
Laboratory Findings in Peripheral Blood
- Pancytopenia
- Normocytic-Normochromic type of anemia with slight macrocytosis
- Normal red cell morphology
- Reticulocyte Count is decreased
- Reticulocyte Production Index is severely decreased
- NO IMMATURE CELLS in the peripheral blood
Laboratory Findings in Bone marrow
- Hypoplastic or aplastic
- Increased fat replacement
- Decreased hematopoietic cells
- Principal cells present are lymphocytes and plasma cells
- No increased number of immature cells
- Patchy areas of cellularity
ANEMIA OF ABNORMAL IRON METABOLISM
- Microcytic
- Hypochromic
is necessary for the synthesis of normal
oxygen carrying hemoglobin.
Iron
Used to evaluate patient with suspected PNH or suspected congenital dyserythpoietic anemia
Ham’s test