Bone Marrow Failure/BMF (2)

Question 1

What occurs here?

What occurs in Haematopoiesis?
→ What is needed for this to occur?

What is its most common cause?

Answer 1

➊ Decreased production of 1+ major hematopoietic lineages

➋ Pluripotent stem cells from bone marrow become RBCs, WBCs, Lymphocytes, and Platelets
→ Hormones and nutrition e.g. Vit B12, Iron, Folate

➌ Aplastic Anaemia

Question 2

Aplastic Anaemia:
What occurs here?

What are its causes?

How does it present?

How is it diagnosed?

How is it managed?

Answer 2

➊ Autoimmune reaction, causing stem cell damage → Hypocellular bone marrow → Pancytopenia

Pancytopenia with a hypocellular marrow (and no abnormal cells suggestive of an alternative e.g. leukaemia)

➋ • Hereditary - Fanconi’s anaemia, Dyskeratosis congenita
• Acquired - Idiopathic, Drugs (e.g. NSAIDs, Chloramphenicol), Infection, Paroxysmal nocturnal haemoglobinuria

➌ Features of pancytopenia

➍ Bone marrow biopsy, showing an absence of stem cells and no evidence of abnormal cells suggestive of an alternative e.g. leukaemia

➎ Transfusions, Immunouppressants, Bone marrow transplant

Question 3

Myelodysplastic Syndromes (MDS):
What is it?

What can it develop into?

How does it present?

How is diagnosed?

How is it managed?

Answer 3

➊ Pre-malignant condition where myeloid stem cells don’t mature properly, therefore not producing enough healthy blood cells

➋ AML

➌ Features of pancytopenia

➍ Bone marrow biopsy

➎ Transfusions, Immunouppressants, Bone marrow transplant