Bone Marrow Failure/HCST Flashcards
What is pancytopenia?
Anemia, leukopenia, and thrombocytopenia.
What is the definition of bone marrow failure?
Pancytopenia due to failure of bone marrow to produce blood cells.
What are the symptoms of anemia?
Dyspnea, chest pain, and fatigue.
What are the symptoms of leukopenia/neutropenia?
Fever, infection, and mouth sores.
What are the symptoms of thrombocytopenia?
Bleeding.
What is the differential diagnosis of pancytopenia?
- Increased destruction: immune destruction, sepsis
- Sequestration: hypersplenism
- Decreased production: myelodysplasia, marrow infiltrate, B12 def, aplastic anemia, drugs, viruses, radiation
In simplest terms, what are the two causes of bone marrow failure?
Hypercellular or hypocellular marrow.
A hypercellular marrow is the result of what?
Infiltration.
What are the 5 causes of bone marrow infiltration?
- Hematological Malignancies (leukemias, myeloma, lymphoma)
- Carcinoma
- Storage disorders
- Myelodysplastic syndromes
- B12 or folate def
What is the cause of a hypocellular marrow?
Aplastic anemia.
What are the 2 forms of aplastic anemia?
- Congenital: Fanconi’s anemia
2. Acquired: idiopathic, myelodysplastic syndrome, drugs/chemicals, radiation, viruses
Define aplastic anemia.
Severe, life-threatening syndrome in which production of erythrocytes, WBCs, and platelets has failed.
What patient population is anemia most likely to be found in?
All. It may occur in all age groups and both genders.
What is aplastic anemia characterized by?
Peripheral pancytopenia accompanied by a hypocellular marrow.
What is the pathophysiology of aplastic anemia?
Reduction or depletion of hematopoietic precursor stem cells with decreased production of all cell lines.
What are the 3 causes of decreased stem cells in aplastic anemia?
- Damage to the pluripotential stem cell
- Defective BM microenvironment
- Cellular or humoral immunosuppression of hematopoiesis (autoimmune)
What are the 2 congenital causes of aplastic anemia?
- Fanconi’s anemia
2. Familial aplastic anemia (subset of Fanconi’s anemia)
Describe Fanconi’s anemia.
Progressive BM hypoplasia. Usually becomes symptomatic around 5 years of age. Skin hyperpigmentation and small stature also observed.
Most cases of aplastic anemia are due to what?
Idiopathic etiology.
Exposure to ionizing radiation can lead to what disease?
Aplastic anemia. Hematopoietic cells especially susceptible to it. Whole body radiation of 300-500 rads can completely wipe out the bone marrow.
What 3 groups of chemical agents can lead to aplastic anemia?
- Contain a benzene ring
- Chemotherapeutic agents
- Certain insecticides
What 2 drugs are known to result in aplastic anemia?
- Chloramphenicol
2. Quinacrine
What 5 infections can lead to aplastic anemia?
- Infectious mononucleosis
- Infectious hepatitis
- Parvovirus
- CMV
- Miliary TB
T or F. In rare cases, pregnancy can result in aplastic anemia.
T