"At present, with the performance of allogeneic bone marrow transplantation, the prognosis of patients with medullary aplasia is improving".
DR. MARÍA MARCOS JUBILAR
SPECIALIST. HAEMATOLOGY AND HAEMOTHERAPY DEPARTMENT
Bone Marrow Aplasia is the disappearance of the cells responsible for blood production in the bone marrow. As a consequence, there is a decrease in red blood cells (RBC), white blood cells (WBC) and platelets in the peripheral blood.
Medullary aplasia can be:
- Total, when it affects the cells that produce red blood cells, leukocytes and platelets.
- Partial, if only one or two of the cell lines are affected.
The Clinic's Hematology and Hemotherapy Service has had a bone marrow transplant program since 1989, as part of the Cellular Therapy Area.
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What are the symptoms of bone marrow aplasia?
The symptomatology of bone marrow aplasia is determined by the degree of involvement of each of the elements that make up blood.
When the production of red blood cells (erythrocytes) is compromised, anemia will appear with its accompanying symptoms of paleness, asthenia, headaches, palpitations, shortness of breath, dizziness, cramps, etc.
If the production of white blood cells (leukocytes) is also altered, the patient will have an exaggerated tendency to suffer from infections, usually caused by rare germs.
Finally, if the production of platelets is compromised, the presence of hemorrhages will be frequent, which may be slight (epistaxis, gingivorrhages) or may compromise the life of the patient (digestive or cerebral hemorrhages).
What are the most common symptoms?
- Tendency to suffer from infections.
Do you have any of these symptoms?
You may have bone marrow aplasia
What are the causes of bone marrow aplasia?
Bone marrow aplasia is an acquired disease. The most frequent agents in its development are infections (mainly viral), drugs and environmental toxic agents (benzol, paints, varnishes, insecticides, etc.).
However, often the cause of the disease cannot be identified (these are the cases known as idiopathic).
What is the prognosis for bone marrow aplasia?
The main prognostic factor for medullary aplasia is the degree of bone marrow involvement. Likewise, the prognosis is conditioned by the number of complications that can occur during the evolution of the disease.
Although until a few years ago the prognosis, especially of severe forms, was relatively poor, at present it has improved with the performance of allogeneic bone marrow transplantation.
How is bone marrow aplasia diagnosed?
Bone marrow aplasia is diagnosed through the hemogram. A decrease in the number of red blood cells, leukocytes and platelets is observed. When cells are observed under the microscope, they are morphologically normal.
Given these results, it is essential to carry out a study of the bone marrow (biopsy), in which a total or partial absence of the cells responsible for producing the blood elements will be observed.
In addition, this study will allow differentiating other hematological processes that can also occur with anemia, leukopenia and/or thrombopenia, as is the case of acute leukemias.
How is bone marrow aplasia treated?
A specific treatment of the disease should be carried out according to the severity of the medullary aplasia.
To alleviate the decrease in leukocytes, infectious diseases should be prevented by administering antibiotics and extreme aseptic measures.
Young patients with severe aplasia should undergo bone marrow transplantation when a suitable donor is found.
Other treatments that can be administered, if no donor is available, are anti-infective or anti-mycotic globulin, corticoids, cyclosporine A, etc.
When aplasia is not severe or the patient is not old enough to undergo a bone marrow transplant, in addition to supportive treatment, hematopoietic growth factors (which stimulate the production of cells by the bone marrow) or immunoglobulins may be administered.
Where do we treat it?
IN NAVARRE AND MADRID
The Hematology and Hemotherapy Service of the
at the Clínica Universidad de Navarra
The Hematology Service of the Clinic, formed by specialists of recognized national and international prestige, has integrated molecular diagnostic techniques and the use of new personalized treatments in its assistance work, allowing a more precise and fast diagnosis of the hematological diseases.
The joint work of the medical staff and the researcher facilitates the development and application of the new treatments and at the same time the precise evaluation of the result of the treatments.
Why at the Clinica?
- Experts in the development of Cellular Therapy treatments.
- International reference center in lymphomas, multiple myeloma and monoclonal gammopathies.
- Experts in the diagnosis and treatment of hemorrhagic and thrombotic problems.