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What Is Bone Marrow Failure?

Three pieces of bone with the marrow in the middle.
Bone marrow failure happens when bone marrow produces insufficient blood cells.
People with bone marrow failure may require blood transfusions.
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  • Written By: John Lister
  • Edited By: Bronwyn Harris
  • Last Modified Date: 15 November 2014
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Bone marrow failure is when the bone marrow either produces insufficient blood cells or none at all. The symptoms can include weakness, bacterial infections or easy bruising. Depending on the severity of the condition, it can be treated with drugs or may require transfusions.

Bone marrow is a flexible tissue which is found inside the hollow centers of bones. It is made up of two types, red and yellow marrow. The red marrow is responsible for producing red blood cells, platelets and most white blood cells. Red blood cells carry oxygen around the body, platelets are involved in blood clotting, and white blood cells are part of the immune system.

The most common result of bone marrow failure is known as pancytopenia. This is where a condition causes a drop in the number of red blood cells. This can be classified as anemia, neutropenia or thrombocytopenia depending on how severely the condition reduces hemoglobin, the key component of red blood cells. Anemia is the smallest reduction and thrombocytopenia the largest reduction.

The severity of the symptoms caused by the bone marrow failure will usually depend on how large the hemoglobin reduction is. Anemia most commonly causes weakness and tiredness, but may also lead to an increased heartrate. Neutropenia can increase the severity and frequency of bacterial infections. Thrombocytopenia can increase the likelihood of bruising or bleeding easily.

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Some forms of bone marrow failure stem from genetic conditions. The most common such cause is Fanconi anemia, often abbreviated to FA. This condition can also cause skeletal problems, short stature and an increased risk of leukemia.

Bone marrow failure can also be an acquired condition. This can be caused by a virus, such as hepatitis B or the Epstein-Barr virus, otherwise known as HHV-4 and one of the most common viruses in humans. The bone marrow failure can also be caused by ionizing radiation or from some types of drug. In rare cases it can develop as a result of chemotherapy, though the condition should end once the chemotherapy ceases.

There are drug treatments for bone marrow failure, with antithymocyte globulin the most common. This is a drug also used in organ transplants to reduce the likelihood, or minimize the effects of, the body rejecting and organ. Another treatment is blood transfusions using blood with particularly high levels of red blood cells and platelets. In severe cases, bone marrow itself can be transplanted.

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Malka
Post 4

Wait, the article says that Epstein-Barr virus (HHV-4) is one of the most common human viruses in existence, and it can cause bone marrow failure? Can you catch HHV-4 from a bone marrow donation?

I'm officially creeped out about ever having to get a bone marrow transplant now for anything less than bone marrow failure, then, or I could make my situation a hundred times worse!

What are the causes of bone marrow failure, anyway? I mean, if you leave a bone marrow problem untreated instead of getting a bone marrow transplant, will you eventually end up with bone marrow failure anyway?

If that's the case, I guess it really isn't making the situation potentially worse by getting a bone marrow transplant with the possibility of it causing bone marrow failure.

SkittisH
Post 3

@hanley79 - Wow, that's so weird about the bone marrow transplant donor's blood type becoming the receiver's new blood type! I'll bet that they try to make the donor's blood type match the receiver's blood type, but probably any compatible blood type for a blood transfusion would also work for a bone marrow transplant, same as it works for organ donations.

That explains why the article talks about drugs used to reduce the chances that the receiver will reject a donor's bone marrow that are also used in organ transplants, too.

If your bone marrow was rejected, that would be seriously bad news -- much worse than if your body rejected one organ, because at least the organ could just be removed again. Imagine your body rejecting something that was already sending cells out into your entire bloodstream...

hanley79
Post 2

Did you know that bone marrow transplants can cause the receiving person to get the donor's blood type?

In fact, it's not a possibility, but a certainty. If you have all of your bone marrow replaced by a donor's, all new red blood cells will be created using that bone marrow, and so your blood type will convert to the blood type of the donor who sent that marrow. It's the weirdest thing to think about!

Imagine in many Asian countries, where they believe that blood type helps determine personality. Does your personality change when you get a bone marrow transplant and switch blood types?

If anybody bothered to study the person's personality before and after the transplant, they could prove once and for all whether blood type actually does affect the personality.

TheGraham
Post 1

Yikes, bone marrow failure would be a severe health risk! Your body replaces all of its red blood cells roughly once every 100 days -- if your bone marrow fails to make any more, you either get blood transfusions or you'll run out of blood cells that deliver oxygen to the brain!

Bone marrow is pretty important stuff. It makes your new red blood cells, and also is vital in creating white blood cells to go to your lymphatic system and defend your body from disease. So if your bone marrow failed, your immune system would also take a pretty huge hit.

What are the symptoms of bone marrow failure as opposed to bone marrow problems? I sure wouldn't want to miss something like that if it was going on inside of my bones.

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