Myelosuppression involves damage to the bone marrow that is either temporary or chronic. As a result, the synthesis of blood cells is impaired. As a result, the number of blood cells produced decreases and various symptoms develop. In numerous cases, myelosuppression occurs as a side effect in the context of chemotherapy. In myelosuppression, damage to the bone marrow occurs, either temporarily or chronically. As a result, the synthesis of blood cells is impaired. As a result, the number of blood cells produced decreases and various symptoms develop. In numerous cases, myelosuppression occurs as a side effect during chemotherapy.
What is myelosuppression?
Myelosuppression is synonymously called bone marrow inhibition or bone marrow depression in some cases. As part of the disease, the usual processes involved in the formation of blood (medical term hematopoiesis) are impaired. The blood formation that takes place in the marrow of the bones is affected. As a result of the impaired synthesis of blood cells, both white and red blood cells are reduced. In addition, the blood platelets decrease. The deficiency of the individual blood cells causes various complaints. The deficit of red blood cells causes anemia, while the deficiency of white blood cells causes neutropenia as well as leukopenia. Thrombocytopenia develops due to the decreased concentration of platelets in the blood. Due to the lack of various blood cells, the immune system and its ability to function are severely attacked. As a result, the affected person suffers from an above-average incidence of infectious diseases, which further weaken the organism and may cause complications. In particular, the reduced number of platelets increases the tendency to bleeding. Due to the anemia, the performance of the ill patient decreases. In addition, affected individuals become tired more quickly. Basically, myelosuppression is a disease that poses a threat to the patient’s life.
Causes
There are many causes of myelosuppression. In principle, all damage to the bone marrow is capable of causing myelosuppression. This is because, as a result of lesions to the marrow of the bone, the formation of blood is significantly disrupted in some cases, so that myelosuppression may develop. The damage to the bone marrow is either exogenous or endogenous. Exogenous causes include radiation therapy, chemotherapy, and radiation sickness. In addition, some drugs damage the bone marrow. This is usually an undesirable side effect. Intolerance reactions to certain drugs cause myelosuppression due to agranulocytosis in some cases. Endogenous causes of myelosuppression include carcinoses of the bone marrow or immune thrombocytopenia. In addition, various pathogens are capable of causing myelosuppression. The focus here is primarily on special types of viruses. These directly infect bone marrow stem cells, for example parvoviruses or cytomegaloviruses. Cytostatic drugs may also trigger the disease, as they have a myelotoxic effect. Unlike cancer cells, stem cells in bone marrow do not become resistant to cytostatic drugs. The negative effects increase with each administration.
Symptoms, complaints, and signs
Myelosuppression includes a variety of symptoms. The main symptoms are anemia, neutropenia, and thrombocytopenia. Anemia occurs when the concentration at the blood pigment hemoglobin or erythrocytes is too low. As a result, the capacity for transporting oxygen through the blood is reduced. In neutropenia, the percentage of granulocytes of neutrophilic type falls below a certain threshold. In thrombocytopenia, platelets are greatly reduced.
Diagnosis and course of the disease
Diagnosis of myelosuppression is either specific or incidental, such as through checkup blood tests performed by a physician. If a person suffers from symptoms typical of myelosuppression, medical consultation and examination are recommended. First, the patient describes to the physician all symptoms as well as medications taken.Complaints such as fatigue, decreased performance and increased susceptibility to infections already raise suspicion of myelosuppression. In the second step, clinical examinations are used. Analyses of the blood are particularly relevant for the diagnosis of myelosuppression. If anemia, neutropenia, and thrombocytopenia are detected in laboratory tests, myelosuppression can be diagnosed with relative certainty. When classifying the findings, the symptoms described by the patient as well as other circumstances also play a role. For example, chemotherapy comparatively clearly indicates myelosuppression and confirms the diagnosis of the disease.
Complications
Myelosuppression causes the patient to experience various complaints and limitations in daily life. As a rule, however, affected individuals suffer from severe fatigue and tiredness. Due to the reduced oxygen transport, the patient’s ability to cope with stress is also greatly reduced, so that he or she may also lose consciousness in the further course of the disease. The susceptibility to various infections and diseases also increases, so that those affected become ill more often. The patient’s quality of life decreases significantly due to myelosuppression. It is not uncommon for the symptoms to occur when various drugs are taken at the same time. In this case, the symptoms can be reduced by discontinuing the drugs or by replacing them with others. This is especially the case with chemotherapy. In this case, there are no further complications. Existing damage to the bones can then heal without complications in most cases. Furthermore, in severe cases, the transplantation of stem cells is necessary to limit the symptoms. In the further course, the affected person is also dependent on treatment of the underlying disease in order to avoid secondary damage. Not infrequently, myelosuppression also reduces the patient’s life expectancy.
When should you see a doctor?
If people taking chemotherapy suffer side effects or impairments, consultation with a physician is necessary. Although the various side effects are known and predictable, clarification of the symptoms should still be obtained. The goal is to assess the extent and ensure that it is within the range of what is expected. Nevertheless, myelosuppression can occur even in people who are not undergoing cancer therapy. Fatigue, low exercise tolerance, and a decrease in usual physical performance should be presented to a physician. If there are changes in the general well-being, a pale complexion and an increased susceptibility to infections, a doctor is needed. If everyday tasks can only be performed with difficulty or no longer to the necessary extent and participation in social and societal life declines, there is a need for action. If rapid fatigue sets in even when performing easy tasks, there is a health irregularity that needs to be investigated and treated. Abnormalities and changes in behavior, severe mood swings, and listlessness should be discussed with a physician. Excessive demands, apathy as well as a change in weight are signs of a present illness. If the complaints persist unabated for several weeks or continuously increase in intensity, a physician is needed to clarify the cause.
Treatment and therapy
Myelosuppression can be treated by various means. If chemotherapy is the trigger for the disease, patients are given certain drugs at the same time that promote the formation of new blood. In this way, it is possible to shorten or weaken the myelosuppression if it is an acute relapse. In general, if myelosuppression is due to chemotherapy, recovery is quite possible. The damage to the marrow of the bone usually heals completely with time. Another case is when the bone marrow stem cells have been irreversibly destroyed. Such myeloablation is desirable in some therapeutic procedures. Then a transplantation of stem cells is necessary to rebuild the marrow of the bone.Timely diagnosis of myelosuppression followed by therapy plays an important role, as it is a life-threatening disease.
Outlook and prognosis
The prognosis of myelosuppression is based on the time of diagnosis, the patient’s constitution, and other factors. If the trigger of the symptoms is identified early, the overall prognosis is favorable. The later the cause of the hemolytic syndrome is identified, the poorer the prospect for recovery. Relatively quickly, the symptoms increase in intensity and the prognosis worsens. Life expectancy without therapy is 20 to 40 percent in the first year. Severe complications, such as the onset of pneumonitis, worsen the prospects for recovery. Quality of life is limited by the discomfort and side effects of therapy. After successful treatment of myelosuppresion, well-being gradually improves. Chemotherapy can cause permanent organ damage and other discomfort. In individual cases, the disease also results in psychological problems and the sufferers develop anxiety disorders or depression. The prognosis of myelosuppression is determined by the responsible specialist. For this purpose, he consults the symptom picture and the previous course of the disease. The prognosis is usually adjusted on an ongoing basis, always in light of current progress in treatment.
Prevention
Preventive measures consist of avoiding the factors that can trigger myelosuppression. Often, however, these are almost without alternative, for example, when chemotherapy is necessary. In myelosuppression, damage to the bone marrow occurs, either temporarily or chronically. As a result, the synthesis of blood cells is impaired. As a result, the number of blood cells produced decreases and various symptoms develop. In numerous cases, myelosuppression occurs as a side effect during chemotherapy.
Follow-up
In most cases, myelosuppression no longer requires direct or special measures of aftercare. The disease can usually be treated relatively well, resulting in no further complications or symptoms. However, the earlier myelosuppression is detected, the better the further course of the disease usually is, so that the affected person should ideally see a doctor at the first symptoms and signs. Most patients with this disease are dependent on various cosmetic procedures that can alleviate and limit the symptoms. These may need to be repeated frequently, so complete limitation of the disease is not possible. Similarly, in myelosuppression, contact with other patients of the disease can be very useful, as it leads to an exchange of information, which can facilitate the daily life of the affected person. Most patients are also dependent on the support and help of their own family during treatment. Loving and intensive conversations also have a positive effect on the further course of myelosuppression and thus also prevent psychological upsets or depression. In some cases, myelosuppression reduces the life expectancy of the affected person.
Here’s what you can do yourself
Myelosuppression requires treatment in all cases. Medical therapy can be supported by sparing and strict adherence to the doctor’s instructions. Because severe physical discomfort usually occurs with the disease, the use of natural pain relievers is useful. In addition to teas, which counteract the tiredness and fatigue, remedies from homeopathy, such as preparations with arnica or belladonna, help. St. John’s wort and other gentle sedatives can also alleviate the symptoms and counteract the reduced performance. In addition, the diet should be changed. In the first weeks after diagnosis, a light diet and avoidance of irritating foods and stimulants of all kinds are recommended. Moderate exercise supports the immune system and has a positive effect on the healing process. Accompanying this, regular consultations with the doctor should be held. Medical advice is always sought, especially in the case of unusual symptoms or side effects from prescribed medication. If the symptoms do not subside or even increase in intensity, further treatment in a specialist clinic is indicated.The physician may refer the patient to an appropriate specialist and include a therapist if needed.
