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Drug-induced Bone Marrow Suppression

Drug Induced Hypoplasia of Bone Marrow


Presentation

  • الصفحة 272 - Salmon SE: A clinical staging system for multiple myeloma: Correlation of measured myeloma cell mass with presenting clinical features, response to treatment and survival. Cancer 36:842-854, 1975 6. ‏[books.google.com]
  • The clinical presentation depends in part upon the etiology and pathogenesis of the agranulocytosis: Immune forms may present days to weeks after beginning the drug and are often acute with explosive symptoms.[wikidoc.org]
  • DIAGNOSIS AND CLINICAL PRESENTATION Agranulocytosis is characterized by a neutrophil granulocyte count 0.5 109/l with no relevant decrease in haemoglobin and platelet counts.[flipper.diff.org]
  • Presentation Whatever the cause, the patient presents with signs and symptoms of: Anaemia - tiredness, weakness, pallor, breathlessness, tachycardia. Neutropenia - recurrent or severe bacterial infections.[patient.info]
  • Clinical presentation Clinically, patients with aplastic anemia present signs of bone marrow failure.[epilepsy.com]
Anemia
  • الصفحة 15 - Eschbach JW, Egrie JC, Downing MR, Browne JK, Adamson JW, Correction of the anemia of end-stage renal disease with recombinant human erythropoietin: Results of a combined phase I and II clinical trial. ‏[books.google.com]
  • […] aplastic anemia D61.01 Constitutional (pure) red blood cell aplasia D61.09 Other constitutional aplastic anemia D61.1 Drug-induced aplastic anemia D61.2 Aplastic anemia due to other external agents D61.3 Idiopathic aplastic anemia D61.8 Other specified[icd10data.com]
  • “Aplastic anemia may be congenital, or develop from Franconi anemia , an inherited disorder,” says Kassim.[everydayhealth.com]
  • 55–57 ) that are likely to be part of the treatment for aplastic anemia.[epilepsy.com]
  • Aplastic or hypoplastic anemia can be idiopathic in nature, or it can develop from secondary causes. Myelodysplastic anemia also can cause pancytopenia. Myelophthisic anemia may result from marrow destruction because of tumor invasion or granulomas.[emedicine.medscape.com]
Swelling
  • […] symptoms: fatigue pale skin, lips, and nail beds increased heart rate tiring easily with exertion dizziness shortness of breath Reduced white blood cells produce classic symptoms of a weak immune system: fever and chills rash diarrhea signs of infection (swelling[diagnose-me.com]
  • Signs of infection may also be present, including swelling, redness or an area that is warm to the touch. Other common neutropenia side effects include diarrhea and rash.[mesothelioma-aid.org]
  • Signs of an allergic reaction include hives; difficulty breathing; and swelling of the face, lips, tongue, or throat.[ehj.eg.net]
  • Side-effects include severe febrile reactions (high fevers); skin reactions (increased coloration- hyperpigmentation) as well as skin inflammation and swelling and thickening of the nail beds.[healthcommunities.com]
Sepsis
  • Seven days following treatment with daily subcutaneous injection of 270 micrograms rHu GM-CSF combined with antibiotics and glucocorticosteroids, granulocytes reappeared in the peripheral blood and the sepsis resolved.[ncbi.nlm.nih.gov]
  • This is called sepsis. Diseases of the immune system Diseases of the immune system, such as HIV, which destroy T lymphocytes Hypersplenism This is caused by enlargement of spleen that destroys the blood cells leading to leukopenia as well as anemia.[news-medical.net]
  • DIA remains a serious adverse event because of the occurrence of severe sepsis with severe deep infections (such as pneumonia), septicemia, and septic shock in around two thirds of patients.[ehj.eg.net]
Lymphadenopathy
  • Presence of hepatomegaly, splenomegaly or lymphadenopathy suggests a diagnosis of leukaemia. Differential diagnosis Systemic lupus erythematosus and hypersplenism - can cause pancytopenia with a normal bone marrow. Leukaemia .[patient.info]
  • Agranulocytosis may be acute or subacute, with fever, regional lymphadenopathy, and complications (fungal infections). In severe cases, jaundice, hematuria, and cylinduria may be observed in patients with agranulocytosis.[ehj.eg.net]
Refractory Anemia
  • Finally, it may arise from lymphoproliferative diseases (eg, lymphomas, chronic lymphocytic leukemia) or collagen vascular diseases (eg, systemic lupus erythematosus, refractory anemia), or it may occur during pregnancy.[emedicine.medscape.com]

Workup

  • As part of the workup for localization of infection, appropriate radiographs (e.g. chest images) are indicated. Other imaging studies can be carried out on the basis of the specific indications of each case.[ehj.eg.net]
Suppression
  • Abstract The haemopoietic growth factors are relatively new additions to the treatment of drug-induced bone marrow suppression. Treatment with growth factors may induce primitive cells to enter into cell cycle.[ncbi.nlm.nih.gov]
  • See also labor . lactation suppression in the nursing interventions classification , a nursing intervention defined as facilitating the cessation of lactation and minimizing breast engorgement after childbirth. overdrive suppression the suppression of[medical-dictionary.thefreedictionary.com]
  • Bone marrow suppression Synonym Myelotoxicity, myelosuppression Bone marrow suppression also known as myelotoxicity or myelosuppression , is the decrease in production of cells responsible for providing immunity ( leukocytes ), carrying oxygen ( erythrocytes[en.wikipedia.org]
  • While it’s a side-effect of treatment itself, suppression of bone marrow can lead to a new set of side effects that may need to be monitored by your doctor.[share.upmc.com]
  • Side effects include decreased white counts at low doses and suppression of all cell lines (pancytopenia) at high doses.[healthcommunities.com]

Treatment

  • Abstract The haemopoietic growth factors are relatively new additions to the treatment of drug-induced bone marrow suppression. Treatment with growth factors may induce primitive cells to enter into cell cycle.[ncbi.nlm.nih.gov]
  • الصفحة 336 - EORTC classification for primary cutaneous lymphomas: a proposal from the Cutaneous Lymphoma Study Group of the European Organization for Research and Treatment of Cancer. Blood 90: 354-371. ‏[books.google.com]
  • Your doctor may notice a drop in blood cell counts about a week after treatment. While it’s a side-effect of treatment itself, suppression of bone marrow can lead to a new set of side effects that may need to be monitored by your doctor.[share.upmc.com]
  • Treatment The treatment of myelosuppression will involve treating whatever the cause of myelosuppression happens to be. If it is related to drugs or chemotherapy, treatments may have to be stopped or delayed.[verywell.com]
  • Use of Lnz is increasing as newer (Group V) drug for the treatment of MDR and XDR pulmonary TB.[jacpjournal.org]

Prognosis

  • Bone-Marrow Disease Anemia and the Link to Blood Cancer The prognosis for bone marrow disease is not encouraging — myelodysplastic syndromes, aplastic anemia, and paroxysmal nocturnal hemoglobinuriacan each progress to blood cancer.[everydayhealth.com]

Etiology

  • Use Additional Use Additional Help Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology.[icd10data.com]
  • The clinical presentation depends in part upon the etiology and pathogenesis of the agranulocytosis: Immune forms may present days to weeks after beginning the drug and are often acute with explosive symptoms.[wikidoc.org]
  • Aplastic Anemia Study was carried out in the 1980s, several epidemiological studies have confirmed some previous findings or have uncovered drugs with a potential risk, such as antithyroid drugs, ticlopidine hydrochloride , spironolactone and clozapine ETIOLOGY[flipper.diff.org]
  • These etiologies involve the following: A decrease in or damage to the hematopoietic stem cells and their microenvironment, resulting in hypoplastic or aplastic bone marrow Maturation defects, such as in vitamin B-12 or folate deficiency Differentiation[emedicine.medscape.com]

Epidemiology

  • […] major books: (1) Toxicology of Organophosphate and Carbamate Compounds, (2) Veterinary Toxicology: Basic and Clinical Principles, (3) Handbook of Toxicology of Chemical Warfare Agents, (4) Anticholinesterase Pesticides: Metabolism, Neurotoxicity, and Epidemiology[books.google.com]
  • EPIDEMIOLOGY Idiosyncratic drug-induced agranulocytosis is a very rare disease. Annual incidence rates in Europe usually range from 1.6 to 9.2 cases per million population per year.[flipper.diff.org]
  • Epidemiology [ 7 ] The annual incidences of paroxysmal nocturnal haemoglobinuria, aplastic anaemia and myelodysplastic syndrome are estimated to be 0.13, 0.2, and 7 per 100,000 population per year respectively.[patient.info]
  • Anemia in HIV infected adults: epidemiology, pathogenesis and clinical management. Curr Hematol Rep 4, 95 –102. [Google Scholar] Forna, F., Liechty, C. C., Solberg, P., Asiimwe, F., Were, W., Mermin, J., Behumbiize, P., Tong, T., Brooks, J.[jmm.microbiologyresearch.org]
  • Epidemiology and Demographics Agranulocytosis has a reported incidence from approximately 1 to 10 cases per million population per year. An association with drug use can be found in about 70 percent of cases.[wikidoc.org]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology and management of thrombocytopenia in bone marrow failure: possible clinical applications of TPO receptor agonists in aplastic anemia and myelodysplastic syndromes. Int J Hematol . 2013 Jul. 98(1):48-55. [Medline] .[emedicine.medscape.com]
  • Pathophysiology & Etiology Most cases of neutropenia are due to decreased granulocyte production or less commonly increased destruction. * Acquired neutropenia is most often due to accelerated turnover, usually resulting from immunologic mechanisms.[wikidoc.org]
  • Pathophysiologic mechanisms, clinical features and treatment of idiopathic neutropenia. Expert Rev Hematol 2008; 1 :217-229. 3. Palmblad JE, von dem Borne AE. Idiopathic, immune, infectious, and idiosyncratic neutropenias.[ehj.eg.net]

Prevention

  • A comparison of filtered leukocyte-reduced and cytomegalovirus (CMV) seronegative blood products for the prevention of transfusion-associated CMV infection after marrow transplant. Blood 1995; 86:3598-3603. ‏[books.google.com]
  • Called also myelophthisis and myelosuppression. labor suppression in the nursing interventions classification , a nursing intervention defined as controlling uterine contractions prior to 37 weeks of gestation to prevent preterm birth .[medical-dictionary.thefreedictionary.com]
  • The use of azathioprine (Imuran; Azasan) is common for a number of conditions, some of which include the prevention of rejection of organ transplantation, inflammatory bowel disease (in particular Crohn's disease), rheumatoid arthritis, systemic lupus[ebmconsult.com]
  • […] painful or warm to the touch) Reduced platelets produce classic excess bleeding symptoms: easy bruising bleeding: nose bleeds, or bleeding gums or mouth tiny red spots on the skin (petechiae) blood in the urine dark or black bowel movements Treatment and Prevention[diagnose-me.com]
  • People with neutropenia often need to take special steps to prevent infections.[webmd.com]

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