Myelosuppression

Simply defined, myelosuppression is defined as the bone marrow making too few blood cells to replace the blood cells that have worn out. It doesn't hurt—a person with myelosuppression does not feel any specific pain from this condition. However, myelosuppression can lead to fatigue, excessive bleeding, or an increased vulnerability to certain infections.

These three conditions are a direct result of myelosuppression, because they are a direct result of a shortage of certain blood cells:

-- Fatigue: This results from a shortage of red blood cells. It is also known as Anemia.

-- Bleeding: This results from a shortage of platelets. It is also known as Thrombocytopenia.

-- Infection risk: This results from a shortage of white blood cells, notably neutrophils. It is also known as Neutropenia.

All of these conditions can be considered a result of myelosuppression.

Causes of Myelosuppression

In the context of cancer treatment, there is one major cause of myelosuppression: chemotherapy. This suppression of the activity of the bone marrow is one of the most commonly cited side effects of chemotherapeutic treatment. It is not generally considered a permanent condition, but rather one that is caused by chemotherapy and one that goes away not long after chemotherapy treatment is ended.

When cancer treatment causes myelosuppression, the next step is typically at the discretion of the patient's physicians. Responding to myelosuppression may involve halting chemotherapeutic treatment to allow the bone marrow to recover; it may involve a red blood cell transfusion to overcome the effects of anemia, or it may involve an injection of so-called growth factors, that encourage the bone marrow to produce neutrophils.

However, if the myelosuppression is considered mild and not affecting the patient, no intervention may be taken. Again, it is up to the patient's physician or oncology team to determine how to address myelosuppression.

To that end, sometimes myelosuppression is treated in a prophylactic manner—meaning before it begins, sometimes by using granulocyte colony-stimulating factor (G-CSF) which can sometimes reduce the severity of the distress on the bone marrow from cancer treatment.

Sources

Medscape: Chemotherapy-Induced Myelosuppression
American Cancer Society: Bone marrow suppression

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