Myelosuppression

In the Myelosuppression damage to the bone marrow occurs, which is either temporary or chronic. As a result, the synthesis of blood cells is impaired. This reduces the number of blood cells produced, so that various ailments develop. In numerous cases, myelosuppression occurs as a side effect of chemotherapy.

Myelosuppression results in damage to the bone marrow, which is either temporary or chronic. As a result, the synthesis of blood cells is impaired. This reduces the number of blood cells produced, so that various ailments develop. In numerous cases, myelosuppression occurs as a side effect of chemotherapy.

What is myelosuppression?

Myelosuppression has a number of symptoms. The main symptoms are anemia, neutropenia, and thrombocytopenia.
© designua - stock.adobe.com

The Myelosuppression becomes synonymous in some cases Bone marrow inhibition or Bone marrow depression called. As part of the disease, the usual processes in the formation of blood (medical term hematopoiesis) are impaired. This affects the blood formation that takes place in the marrow of the bones.

As a result of the disturbed synthesis of blood cells, both white and red blood cells are reduced. In addition, the platelets decrease. The lack of 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. The immune system and its functionality are strongly attacked by the lack of various blood cells. As a result, the affected person suffers more than average from infectious diseases, which weaken the organism further and possibly lead to complications.

In particular, the reduced number of blood platelets increases the tendency to bleeding. Due to the anemia, the patient's performance decreases. In addition, the affected people get tired faster. Basically, myelosuppression is a disease that poses a threat to patient life.

causes

The causes for the development of myelosuppression are manifold. In principle, all damage to the bone marrow is capable of triggering myelosuppression. Because as a result of lesions on the marrow of the bone, the formation of blood is in some cases significantly disrupted, so that myelosuppression may develop. The damage to the bone marrow is either exogenous or endogenous. Exogenous causes are, for example, radiation or chemotherapy as well as radiation sickness.

Some medicines also damage the bone marrow. This is usually an undesirable side effect. The intolerance reactions to certain drugs cause agranulocytosis in some cases to cause myelosuppression. Endogenous reasons for the development of myelosuppression are, for example, carcinosis of the bone marrow or immune thrombocytopenia.

In addition, various pathogens are able to cause myelosuppression. The focus here is primarily on special types of viruses. These directly infect the bone marrow stem cells, for example parvoviruses or cytomegaloviruses. Cytostatics can also trigger the disease, as they have a myelotoxic effect. Unlike cancer cells, stem cells in the bone marrow do not become resistant to the cytostatics. The negative effects increase with each administration.

Symptoms, ailments & signs

Myelosuppression has a number of symptoms. The main symptoms are anemia, neutropenia, and thrombocytopenia. Anemia is when the concentration of the blood pigment hemoglobin or erythrocytes is too low. As a result, the capacity to transport oxygen via the blood is reduced. In the context of neutropenia, the proportion of granulocytes of the neutrophil type falls below a certain limit value. In thrombocytopenia, the platelets are greatly reduced.

Diagnosis & course of disease

The diagnosis of myelosuppression is either targeted or random, for example through blood check-ups by the doctor. If a person has symptoms typical of myelosuppression, medical advice and an examination are recommended. First, the patient describes to the doctor all symptoms and medicines he has taken.

Complaints such as fatigue, decreased performance and an increased susceptibility to infections already lead the suspicion to myelosuppression. In the second step, clinical examinations are used. Analyzes of the blood are particularly relevant for diagnosing myelosuppression.

If laboratory tests show anemia, neutropenia, and thrombocytopenia, the myelosuppression can be diagnosed with relative certainty. When classifying the findings, the complaints described by the patient and other circumstances also play a role. For example, chemotherapy is a relatively clear indication of myelosuppression and confirms the diagnosis of the disease.

Complications

The myelosuppression leads to various complaints and limitations in everyday life. As a rule, however, those affected suffer from severe exhaustion and tiredness. The reduced oxygen transport also results in a greatly reduced resilience of the patient, so that he can lose consciousness in the further course of the disease.

The susceptibility to various infections and diseases also increases, so that those affected get sick more often. The quality of life of the patient decreases significantly due to the myelosuppression. It is not uncommon for the symptoms to occur when different drugs are taken at the same time.

Symptoms can be reduced by stopping the medication or by replacing the medication with others. This is especially the case with chemotherapy. There are no further complications. Existing damage to the bones can then heal again without complications in most cases.

In severe cases, stem cell transplantation is also required to limit the symptoms. In the further course, the person concerned is also dependent on the treatment of the underlying disease in order to avoid consequential damage. It is not uncommon for myelosuppression to reduce the patient's life expectancy.

When should you go to the doctor?

If people who are undergoing chemotherapy suffer from side effects or impairments, they must consult a doctor. Although the various side effects are known and foreseeable, the symptoms should still be clarified. The aim is to assess the extent and ensure that it is within the range of what can be expected. However, myelosuppression can occur in people who are not undergoing cancer therapy.

A doctor should be presented with exhaustion, low resilience and a decrease in normal physical performance. If there are changes in general well-being, pale skin or an increased susceptibility to infections, a doctor is required. If everyday obligations can only be carried out with difficulty or no longer to the necessary extent and if participation in social and societal life falls, there is a need for action.

If fatigue develops quickly even when performing light tasks, there is a health irregularity that needs to be examined and treated. Abnormal behavior and changes in behavior, strong mood fluctuations and indifference should be discussed with a doctor. Excessive demands, apathy and a change in weight are signs of an existing illness. If the symptoms persist for several weeks or if they continuously increase in intensity, a doctor is required to clarify the cause.

Treatment & Therapy

Myelosuppression can be treated with a variety of means. If chemotherapy triggers the disease, the patient is given certain drugs at the same time that encourage the formation of new blood. In this way, the myelosuppression can be shortened or weakened if it is an acute flare-up.

In principle, recovery is possible with myelosuppression as a result of chemotherapy. The damage to the marrow of the bone usually heals completely over time. Another case is when the bone marrow stem cells have been irreversibly destroyed.

Such a myeloablation is desirable in some therapeutic procedures. A stem cell transplant is then required to rebuild the marrow of the bone. A timely diagnosis of myelosuppression with subsequent therapy plays an important role since it is a life-threatening disease.

Outlook & forecast

The prognosis of myelosuppresion is based on the time of diagnosis, the constitution of the patient and other factors. If the cause of the complaints is identified early, the prognosis is generally favorable. The later the cause of the hemolytic syndrome is identified, the worse the prospect of recovery.

The symptoms increase in intensity relatively quickly and the prognosis worsens. Life expectancy without therapy is 20 to 40 percent in the first year. Serious complications such as pneumonitis worsen the chances of recovery. The quality of life is limited by the symptoms and the side effects of the therapy.

After successful treatment for myelosuppression, well-being gradually improves. Chemotherapy can cause permanent organ damage and other complaints. In individual cases, the disease also leads to mental problems and the sick develop anxiety disorders or depression. The prognosis of the myelosuppresion is made by the responsible specialist. He consults the symptoms and the previous course of the disease. The prognosis is usually adjusted continuously, always in view of the current progress of the treatment.

prevention

Preventive measures consist of avoiding the factors that can trigger myelosuppression. Often, however, there is almost no alternative, for example when chemotherapy is necessary. Myelosuppression results in damage to the bone marrow, which is either temporary or chronic.

As a result, the synthesis of blood cells is impaired. This reduces the number of blood cells produced, so that various ailments develop. In numerous cases, myelosuppression occurs as a side effect of chemotherapy.

Aftercare

In most cases, direct or special follow-up measures are no longer necessary for myelosuppression. The disease can usually be treated relatively well so that there are no further complications or complaints. However, the earlier the myelosuppression is detected, the better the further course of the disease is, as a rule, so that the person affected should ideally see a doctor at the first symptoms and signs.

Most patients with this disease are dependent on various cosmetic interventions that can alleviate and limit the symptoms. These may have to be repeated more often so that a complete limitation of the disease is not possible. In the case of myelosuppression, contact with other patients with the disease can also be very useful, as this leads to an exchange of information that can make everyday life easier for the person affected.

Most patients also need family support and help during treatment. Loving and intensive discussions also have a positive effect on the further course of myelosuppression and thus also prevent psychological upsets or depression. In some cases, myelosuppression decreases the life expectancy of the person affected.

You can do that yourself

Myelosuppression always requires treatment. Medical therapy can be supported by restraint and strict adherence to medical guidelines.

Since the disease usually causes severe physical discomfort, it makes sense to take natural painkillers. In addition to teas, which counteract 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 few weeks after the diagnosis, light diets and the avoidance of irritating foods and stimulants of all kinds apply. Moderate exercise supports the immune system and has a positive effect on the healing process.

In addition, you should consult your doctor on a regular basis. In any case, medical advice is required, especially in the event 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 doctor can refer the patient to a suitable specialist and, if necessary, also involve a therapist.