Non-regenerative Anemia / Polycythemia Flashcards
what do we see, broadly, in the case of a primary bone marrow disorder?
-generalized depression
-multiple cytopenias
what do we see, broadly, in the case of a secondary bone marrow disorder?
selective red cell depression
how can primary bone marrow disease arise?
Progenitor cells can be injured by exposure to chemicals, drugs, toxins, irradiation, viruses and through immune-mediated mechanisms. Usually these injuries are not cell-line specific or occur early enough in differentiation that common stem cells are affected; the result is that multiple cell lines are affected
what do we see in the peripheral blood in cases of primary one marrow disease?
nonregenerative anemia, leukopenia, and thrombocytopenia
what 4 broad categories of primary bone marrow disease are there?
-hypoplasia or aplasia
-myelodysplasia
-leukemia
-other reasons for myelophthisis
what can cause bone marrow hypoplasia or aplasia?
-Infectious – eg. FeLV, ehrlichiosis
-Drug/chemical toxicity
-Immune-mediated
what are some examples of drugs/chemicals that can result in bone marrow aplasia or hypoplasia?
◦ Estrogen
◦ Phenobarbital
◦ Griseofulvin
◦ Cephalosporins
◦ Chemotherapeutic agents
what are some factors that can result in estrogen toxicity?
-Exogenous administration
-Sertoli cell tumors
-Persistent estrus in ferrets
what are the criteria for diagnosis of Myelodysplasia/Myelodysplastic
Syndrome
◦ Peripheral blood cytopenia(s)
◦ Normal to hypercellular bone marrow
◦ Dysplastic features
what is leukemia?
Myeloproliferative disease is used interchangeably with leukemia to denote hematopoietic neoplasia arising from bone marrow cells
-Tumor of developing red cells, white cells (except lymphs) or platelets
-Can replace normal marrow with neoplastic cells
what is myelophthisis?
displacement of hemopoietic bone-marrow tissue by fibrosis, tumors, or granulomas. The word comes from the roots myelo-, which refers to bone marrow, and phthysis, shrinkage or atrophy.
- leading to peripheral cytopenias
what is myelofibrosis and what is its cause?
-proliferation of fibroblasts within the bone marrow cavity caused by:
FeLV-related
Marrow necrosis
Neoplasia
Chronic hemolytic anemia
=> often the cause in unknown
what are dacrocytes and when do we see them?
These tear drop cells are found primarily in diseases with bone marrow fibrosis, such as: primary myelofibrosis, myelodysplastic syndromes during the late course of the disease, rare form of acute leukemias and myelophthisis caused by metastatic cancers
what do we see in the blood in a case of primary bone marrow disease?
Non-regenerative anemia
Leukopenia +/- abnormal cells
Thrombocytopenia
what do we in the blood in a case of secondary bone marrow disease?
Non-regenerative anemia
Normal or increased leukocytes
Normal or increased platelets
what 5 factors are often the cause of secondary bone marrow disease?
-chronic inflammation
-endocrine disease
-FeLV related
-metastatic neoplasia
-renal disease
what causes anemia of chronic disease? What are its charactieristics?
-Inflammation (infectious/non-infectious) & neoplasia
-Due to poor iron availability, suppressive cytokines
-Usually mild-moderate
◦ E.g dog: HCT usually between .20 and .30 (ref int.
.37-.55)
-Normocytic, normochromic anemia
what hormone deficiencies can cause anemia of endocrine disease?
◦ Cortisol
◦ Androgens
◦ Thyroxine
◦ Growth hormone
what are the characteristics of anemia that results from FeLV infection?
Anemia can be normocytic or macrocytic
Can cause nonregenerative anemia via:
◦ Anemia of chronic disease
◦ Myelophthisis from hematologic neoplasia
◦ Pure red cell aplasia (PRCA)
what are the characteristics of anemia of renal disease? what are its characteristics?
Usually a moderate anemia, may be worse if bleeding or decreased platelet function
Due to:
• Decreased red cell life span
• Decreased Epo production
• Decreased marrow responsiveness to Epo
what can Rubricytosis, Lead Toxicity, or Vitamin & Mineral
Deficiencies lead to
anemia due to secondary bone marrow disease
with polycythemia, how will RBC, Hgb, and Hct values be impacted?
increased
what is polycythemia? what are the broad categorizations?
increased number of red cells in the blood, due to primary disease or a secondary condition
-Relative polycythemia: normal red cell mass
-Absolute polycythemia: increased red cell mass
what are the types of absolute polycythemia?
Primary: Decreased-Normal Epo, Normal PO2
Secondary: Increased Epo, Low PO2
what causes primary absolute polycythemia?
Myeloproliferative disease: polycythemia vera or erythrocytosis
what causes secondary absolute polycythemia?
Many causes (Cariopulmonary disease, high altitude, hormone excess, renal masses, paraneoplastic)
what is the most common cause of polycythemia?
dehydration
what causes relative polycythemia? what are its identifying characteristics?
dehydration or splenic contraction
No change in Epo or PO2
what is polycythemia vera
PV is a myeloproliferative disease involving neoplastic transformation of an erythroid stem cell. The red cells are morphologically normal
what do we sometimes see in long-standing cases of absolute polycythemia and why?
there will be increased demand for iron. For this reason, microcytosis and hypochromia are sometimes observed in long-standing cases of absolute polycythemia
