Myelosuppression

Introduction Myelosuppression refers to a decrease in the activity of blood cell precursors in the bone marrow. Both red blood cells and white blood cells in the bloodstream are derived from stem cells in the bone marrow. The blood cells in the bloodstream have a short life span and often need to be replenished. In order to achieve timely replenishment, stem cells that are precursors of blood cells must divide rapidly. Chemotherapy and radiation, as well as many other anti-tumor therapies, are directed at rapidly dividing cells and thus often cause normal bone marrow cells to be suppressed.

Cause

Myelosuppression is a common toxic reaction of most chemotherapeutic drugs. Most chemotherapeutic drugs can cause different degrees of myelosuppression, reducing the number of peripheral blood cells. Blood cells are composed of various components, each of which is indispensable to the human body. The effect, the reduction of any one component, causes the body to produce corresponding side reactions. The more common drugs such as doxorubicin, taxol, carboplatin, ifosfamide, vinblastine and other chemotherapy (Chemotherapy) and radiation therapy, as well as many other anti-tumor treatments, are directed at rapidly dividing cells. This often leads to suppression of normal bone marrow cells.

an examination

Related inspection

Bone marrow image analysis of morphological examination of bone marrow cells

Myelosuppression usually occurs after chemotherapy. Because the average survival time of granulocytes is the shortest, about 6-8 hours, bone marrow suppression is often the first to show a decrease in white blood cells. The average survival time of platelets is about 5-7 days, and the decrease is later, the average survival time of red blood cells. For 120 days, it is less affected by chemotherapy, and the decline is usually not obvious. Myelosuppression caused by most chemotherapy drugs is usually seen in 1-3 weeks after chemotherapy, and gradually recovers for about 2-4 weeks. It is mainly caused by leukopenia, and may have thrombocytopenia. A few drugs such as Gemcitabine, Carboplatin, and Silk Schizomycin and the like are mainly caused by thrombocytopenia. Therefore, the number of white blood cells and platelets can be detected after chemotherapy to determine whether bone marrow suppression has occurred.

Differential diagnosis

Level of diagnosis of myelosuppression: The degree of inhibition of bone marrow is classified into 0 to IV according to WHO: 0: white blood cells 4.0 × 10 ⁹ /L, hemoglobin 110 g / L, platelets 100 × 10 ⁹ / L, grade I: white blood cells (3.0 to 3.9) × 10 ⁹ /L, hemoglobin 95 to 100 g/L, and platelets (75 to 99) × 10 ⁹ /L. Grade II: white blood cells (2.0 to 2.9) × 10 ⁹ /L, hemoglobin 80 to 94 g / L, platelets (50 to 74) × 10 ⁹ / L. Grade III: white blood cells (1.0 to 1.9) × 10 ⁹ /L, hemoglobin 65 to 79 g / L, platelets (25 to 49) × 109 / L. Grade IV: white blood cells (0 to 1.0) × 109 / L, hemoglobin.

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