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bone marrow hypoplasia/failure (myelosuppression)
Suppression of hematopoiesis within the bone marrow. Any & all hematopoietic cell lines may be affected, resulting in:
1) aplastic anemia
2) leukopenia*
3) thrombocytopenia
* lymphocytes are generally spared
Etiology:
- inherited
- Fanconi anemia
- dyskeratosis congenita
- Diamond-Blackfan syndrome
- Shwachman-Diamond syndrome
- acquired
- aplastic anemia
Pathology:
- hypoplasia of one or more cell lines in the bone marrow
- lymphocytes are generally spared
Laboratory:
- complete blood count (CBC)
- bone marrow biopsy
- sucrose hemolysis test (Ham test)
Radiology:
- magnetic resonance imaging (MRI)
- positron emission tomography (PET)
Differential diagnosis:
- acquired form
- myelodysplastic syndrome
- paroxysmal nocturnal hemoglobinuria
- large granular lymphocyte leukemia
- acute myelogenous leukemia
- aplastic anemia
- hairy cell leukemia
Management:
- transfusion as needed
- febrile neutropenia is a medical emergency
- bone marrow transplantation
- specifc therapies for specific disorders
Specific
hypoplastic anemia
leukopenia
pancytopenia
General
bone marrow disease
hypoplasia
References
- Besa EC and Woermann UJ
eMedicine: Bone Marrow Failure
- Shimamura A.
Clinical approach to marrow failure.
Hematology Am Soc Hematol Educ Program. 2009:329-37
PMID: 20008218