Bone Marrow Failure (haematology)

Question 1

What are the causes of bone marrow failure? (4)

Answer 1

•Infiltration by abnormal tissues
-Myelofibrosis
•Ineffective haematopoiesis
-Megaloblastic anaemia
-Myelodysplasia
•Replacement of the marrow with malignant cells
-Primary and secondary
•Primary reduction in haematopoietic cells
-Aplastic anaemia

Question 2

What is aplastic anaemia? (3)

Answer 2

-Pancytopenia resulting from aplasia of the bone marrow.
-Reduction in the number of haematopoietic pluropotential stem cells.
-Fault in the remaining cells/ immune response against them.

Question 3

What are the ….. causes of aplastic anaemia?
1. Primary (4)
2. Secondary (4)

Answer 3

1. Congenital, idiopathic aplastic anaemia, dyskeratosis congenita, fanconi anaemia.
2. Chemicals , drugs, viruses, Ionising radiation.

Question 4

What are the functions of the ff and what disorder is causes by the deficiency in them?
1. RBCs
2. Neutrophils
3. Platelets

Answer 4

1. Carry oxygen, anaemia
2. Fight infections, infections
3. Coagulation, bleeding tendency

Question 5

Laboratory findings in aplastic anaemia? (5)

Answer 5

-Hypocellular bone marrow.
-No abnormal cells in the peripheral blood.
-Anaemia
-Leukopenia
-Thrombocytopenia

Question 6

What are the treatment methods for aplastic anaemia? (7)

Answer 6

•General
-Supportive care
-Prevention of infection
-Prophylaxis
•Specific
-SCT
-ACG
-Alemtuzumab
-Ciclosporin

Question 7

What are the cytopenias seen with specific bone marrow failure? (3)

Answer 7

Pure red cell aplasia
Thrombocytopenia
Granulocytopenia

Question 8

What are the causes of pure red cell aplasia? (5)

Answer 8

Acute
-Parvovirus infection, idiopathic.
Chronic congenital
-Diamond-blackfan syndrome
Chronic acquired
-Associated with various conditions.
-Idiopathic

Question 9

What are the two examples of granulocytopenia?

Answer 9

Congenital neutropaenia
Cyclical neutropaenia

Question 10

What are the causes of thrombocytopenia?

Answer 10

Inherited
-TAR
-Congenital amegakaryocytic thrombocytopenia.
Acquired
-Amegakaryocytic thrombocytopenia

Question 11

When do you suspect bone marrow failure?

Answer 11

When there are clinical symptoms such as anaemia, bleeding tendencies and/or infections.

Question 12

How do you make a diagnosis of bone marrow failure? (6)

Answer 12

•Full blood count with differential count.
-Low counts
•Reticulocyte count
-Low absolute count and %
•Bone marrow aspirate with biopsy
-To identify the underlying cause.