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.
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.