Bone Marrow Failure: Symptoms, Causes, and Treatment

What is Bone Marrow Failure?

Bone marrow failure (BMF) is a condition that affects your bone marrow’s ability to produce any type of blood cell – white, red, or platelets. Although this ailment is quite rare, affecting about 65 in 1 million, it can affect kids and adults.

One of the most challenging aspects of bone marrow failure disease is that it can lead to several severe health complications and the development of cancerous cells.

Types of Bone Marrow Failure

Bone marrow failure disorders are of two types:

• Acquired bone marrow failure (ABMF) –

Here, patients acquire the disease over a period of time. There can be several reasons for this – certain medications, infections, exposure to toxic chemicals, and more.

• Inherited bone marrow failure (IBMF) —

Here, patients inherit the disease from one or both parents due to a gene mutation process. According to studies, at least 30% of bone marrow issues in children belong to the IBMF type.

IBMF can further be divided into various types, such as the following —

◦ Aplastic Anaemia

◦ Fanconi Anaemia

◦ Dyskeratosis Congenita

◦ Shwachman-Diamond Syndrome

◦ Congenital Amegakaryocytic Thrombocytopenia

◦ Diamond Blackfan Anaemia

◦ Reticular Dysgenesis

Rare forms of IBMF include:

◦ Kostmann Syndrome

◦ Paroxysmal Nocturnal Haemoglobinuria

◦ Pearson Syndrome

◦ Short Telomere Syndrome

◦ Thrombocytopenia Absent Radii Syndrome

Symptoms of Bone Marrow Failure

Some symptoms may be different based on the type of bone marrow failure. Common symptoms seen in all types of BMF are:

• Anaemia

• Pain in the bones

• Tendency to bleed easily

• Frequent bruising

• Extreme tiredness

• Becoming very prone to infections

• Headaches

• Sudden fever

• Pale and dull-looking skin

• Dyspnoea (breathlessness)

• Petechiae (appearance of small blood spots beneath the skin)

• Haemorrhage

Causes of Bone Marrow Failure

Based on its type, bone marrow failure disorders can be caused due to:

• IBMF –

When a child inherits the gene from one or both parents, leading to gene mutations

• ABMF –

The causes for acquired bone marrow failure are:

◦ Disorders related to autoimmune conditions

◦ Specific types of cancers, like large granular lymphocytic leukaemia, lymphoma, multiple myeloma, and more

◦ Certain arthritis medications and antibiotics

◦ Exposure to chemicals, especially those found in pesticides, insecticides, fertilisers, and more

◦ Cancer treatments (including radiation and chemotherapy)

◦ Myelodysplasia (a condition where there aren’t enough blood cells, leading to extreme anaemia)

◦ Paroxysmal nocturnal haemoglobinuria (a condition that causes quick damage to the red blood cells)

◦ Certain severe viral infections (like hepatitis, HIV, and Epstein-Barr virus)

Risk Factors of Bone Marrow Failure

This includes:

• Kids aged 2 to 5 (IBMF is more common in kids; mostly, these are autosomal recessive cases, where kids inherit the gene from both parents, but the parents don’t show any symptoms)

• Adults aged 20 to 25 (ABMF is more common in adults)

• Senior citizens above 65 years

Diagnosis of Bone Marrow Failure

To diagnose bone marrow failure, doctors may use any of the following procedures:

• Personal medical history

• Physical examination of the affected parts

• Blood tests (including a CBC and iron & vitamin deficiency test)

• Bone Marrow Biopsy

• Imaging tests

• Ultrasound scans to check swollen liver, spleen, etc.

Treatment of Bone Marrow Failure

The patient’s age, the severity of bone marrow failure, symptoms visible, and other factors will help doctors decide the appropriate treatment method for this condition. Treatment for short-term solutions could include the following:

• Hospitalisation and antibiotics when your WBCs are extremely low

• Blood transfusion to increase RBC and platelet count

• Stimulants to increase the bone marrow’s capability to produce blood cells

• Immunosuppressants to improve functioning of the immunity system

• Corticosteroids and androgens to improve the production of blood cells in the bone marrow

The only long-term solution to treat bone marrow failure is a bone marrow transplant, also known as a stem cell transplant. To conduct this treatment, the doctor gets healthy cells from a suitable donor and replaces it with your unhealthy cells. This treatment is suitable for people aged less than 55 years.

FAQs

1. Is it possible to prevent being diagnosed with bone marrow failure?

Preventing BMF can be challenging, as many causes are not entirely understood or are related to genetic factors. However, certain strategies may help reduce risk or support overall bone marrow health.

2. Can you treat bone marrow failure?

Medications and blood transfusion may provide temporary relief from this condition; however, the long-term solution for this condition is undergoing stem cell transplant procedure.