Bone Marrow Indications and Collection

Question 1

Aplastic anemia

Answer 1

• Pancytopenia (RBCs, WBCs, and platelets are all decreased)

- Absence of active marrow

Question 2

Parvovirus

Answer 2

• Regenerative or non-regenerative anemia
• Mitotic cells are infected and killed
• Would see a leukopenia
• Would see a thrombocytopenia
• Infectious cause of aplastic anemia

Question 3

Estrogen toxicity

Answer 3

• Non-regenerative anemia
• Pancytopenia
• Hematopoietic progression:
  1. Platelets decrease
  2. Leukocytes decrease
  3. Erythrocytes decrease

Question 4

Anemia of inflammatory disease (AID)

Answer 4

• Non-regenerative anemia
• Erythroid hypoplasia
• Hct would NOT be <20%

Question 5

Chronic renal disease

Answer 5

• Non-regenerative anemia (affecting EPO production)
• Erythroid hypoplasia
• Would NOT see hypoplasia in other cell lines
• BUN, Creatinine, and SG elevation

Question 6

Immune-mediated destruction of erythroid precursors

Answer 6

• Regenerative anemia (in bone marrow response and CBC)

- Erythroid hypoplasia (increased M:E)

Question 7

Immune-mediated hemolysis

Answer 7

• Regenerative anemia
• Erythroid hyperplasia
• Peripheral destruction

Question 8

Acute blood loss

Answer 8

• Most likely a non-regenerative anemia
• Erythroid hyperplasia
• Would NOT see an inflammatory leukogram
• Takes 3-5 days to recover

Question 9

Physiologic response to hypoxia

Answer 9

• Regenerative anemia

- Erythroid hyperplasia

Question 10

Iron deficiency anemia (IDA)

Answer 10

• Non-regenerative anemia
• Ineffective erythropoiesis
• -Normal or increased erythroid activity with a decreased M:E
• -Not making it to the peripheral blood
• Typically see thrombocytosis
• -Megakaryocytic hyperplasia
• -Inflammatory condition
• -Lots of cytokines
• -Drives thrombopoiesis up

Question 11

Paraneoplastic conditions

Answer 11

• Erythroid hyperplasia

- Can create EPO

Question 12

B12 and folate deficiency

Answer 12

• Erythroid hyperplasia

- Macrocytic

Question 13

Polycythemia vera

Answer 13

• Erythroid hyperplasia

- Neoplastic, therefore does not need EPO

Question 14

Immune-mediated thrombocytopenia (ITP)

Answer 14

• Megakaryocytic hyperplasia

- Peripheral destruction

Question 15

Disseminated intravascular coagulation (DIC)

Answer 15

-Megakaryocytic hyperplasia

Question 16

Essential thrombocythemia (ET)

Answer 16

• Megakaryocytic hyperplasia

- Similar to polycythemia vera

Question 17

Granulocytic neoplasm

Answer 17

• Non-regenerative anemia
• Granulocytic hyperplasia
• Thrombocytopenia
• Myelopthesis (crowding out, no place to grow and proliferate)

Question 18

Johne’s Disease

Answer 18

• Non-regenerative anemia

- Inflammatory leukogram

Question 19

Pyometra

Answer 19

• Non-regenerative anemia

- Inflammatory leukogram

Question 20

Immune-mediated bicytopenia (Evan’s Syndrome)

Answer 20

• Regenerative anemia
• Hyperplasia in all three lines in bone marrow
• Cytopenia in two lines in CBC
• -Destruction of RBCs and platelets in the peripheral blood

Question 21

Endocrine disorders

Answer 21

• Mild non-regenerative anemia

- Hypothyroid and Addison’s cases

Question 22

Pure red cell aplasia

Answer 22

• Severe non-regenerative anemia
• Reticulocytopenia
• Absence of, or severe deficiency of, nucleated erythroid precursors in otherwise normal bone marrow
• Leukocyte and thrombocyte counts WNL
• Seen in cases of thymoma, drugs, toxins, autoimmune, FeLV, MDS, chronic leukemias, etc.
• -Reported in FeLV sub C positive adult cats
• -Also reported in FeLV negative kittens with immune-mediated destruction that is directed at the level of early red cell precursor