There are a number of different bone marrow diseases, but most are directly related to the blood and blood cell production. Polycythemia vera, for instance, is a disease in which a person makes too many red blood cells, whereas leukemia is a cancer that impacts primarily white blood cells. Lymphoma is a blood cancer that targets the lymph nodes, and those with myeloma have problems with their platelets. Aplastic anemia, in turn, hinders production of red cells, white cells, and platelets. The prognosis for each condition is different and specific to the individual patient. A lot depends on when the disease is caught and whether it has spread to other parts of the body. In general, though, these conditions tend to be treatable in most people.
Bone Marrow Basics
Bone marrow is the soft, spongy tissue that fills in the center of most bones, and it is most prolific and dense in the bigger bones like the hip and thigh bones. The marrow is where the bulk of the body’s blood cell production takes place. Cells that are created in the marrow are then released into the bloodstream to circulate to the organs, including the brain and heart. Blood is typically made of three main parts. Red blood cells carry oxygen, white blood cells fight infection in the body, and platelets allow the blood to clot.
Bone marrow problems most commonly involve the blood. Overproduction or underproduction of blood cells, production of abnormal blood cells, or initial defects in the stem cells are the most common examples. Sometimes defects are a one-time thing, but in most cases they’re a result of a specific disorder or disease. Common symptoms of bone marrow disease include infection, anemia, fevers and weight loss. Symptoms can be varied from person to person. Additionally, most have “seasons” or cycles that alternate between flare-ups and remission. In most cases diagnosis requires a full physical exam as well as a lot of blood work.
Polycythemia vera (PV) is a type of bone marrow disease in which the bone marrow makes excessive amounts of red blood cells, which results in blood that is extremely thick. This condition is associated with an increased risk of heart attack, blood clots, and stroke. PV can often be treated with phlebotomy treatment, in which patients undergo a removal of about one pint of blood per week in order to thin the blood. Certain medications, such as hydroxyurea and interferon-alpha, can also be used to help prevent the bone marrow from making excessive red blood cells. In some cases, radiation is used to stop the overproduction.
Leukemia and Lymphoma
Leukemia is a type of cancer that affects the white blood cells, which causes them to continuously multiply and mature to the point that they crowd other cells in the region. Leukemia can either be acute or chronic. Acute lymphocytic leukemia primarily affects children, while acute myeloid leukemia is most commonly seen in adults. Many types of leukemia can be treated, and some can be cured. Common treatments include bone marrow transplant, chemotherapy, radiation therapy, and stem cell transplant. Treatments also may include antibiotics, blood transfusions, and surgery.
The lymph nodes and the immune system can also be affected by lymphoma, which is a cancer involving cells called lymphocytes. The exact cause of this bone marrow disease is not known, but there are several risk factors involved, including certain infections, autoimmune disease, age, and family history. Treatment options for lymphoma frequently involve chemotherapy, radiation therapy and biological therapy.
A bone marrow cancer called multiple myeloma can occur when plasma cells become so overgrown that they become tumors. The cells accumulate and circulate through the blood, eventually overwhelming the production of healthy cells in other parts of the body. The renegade cells then interfere with the immune system’s ability to fight infection. Causes of the condition are unknown, but it tends to be more common among the elderly and among those of African descent. This type of cancer is difficult to cure and doctors often focus on treating the symptoms to keep patients comfortable. Some treatment options include chemotherapy, radiation therapy, bone marrow transplant, pain management medication, and surgery.
Aplastic anemia is a bone marrow disorder that hinders or completely stops the production of red blood cells, white blood cells, and platelets. More often, though, red blood cells are most heavily impacted. Aplastic anemia is usually caused by exposure to radiation or to toxins, such as those used in pesticides and insecticides. Some medications, such as those used to treat arthritis, can also be a causal factor, as can viruses that attack bone marrow such as hepatitis and HIV. In aplastic anemia the stem cells, the precursors of the other three blood cells, do not replicate normally. Therefore, the bone marrow produces a very decreased amount of healthy blood cells. Treatment for aplastic anemia can include bone marrow transplant, bone marrow transfusion, and oxygen therapy.