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Drug-induced Bone Marrow Suppression

Drug Induced Hypoplasia of Bone Marrow


Presentation

  • Seite 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]
  • Blasts may not be present on the peripheral smear, but usually can be found.[academic.oup.com]
  • In the present study, an elderly patient admitted to the ICU presented with thrombocytopenia, which was associated with TZP treatment.[spandidos-publications.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]
Anemia
  • Seite 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 may be congenital, or develop from Franconi anemia , an inherited disorder,” says Kassim.[everydayhealth.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]
  • 55–57 ) that are likely to be part of the treatment for aplastic anemia.[epilepsy.com]
  • Blood transfusions Treatment for aplastic anemia usually involves blood transfusions to control bleeding and relieve anemia symptoms. Blood transfusions aren't a cure for aplastic anemia.[mayoclinic.org]
Italian
  • Hairy cell leukemia: a clinical review based on 725 cases of the Italian Cooperative Group (ICGHCL)—Italian Cooperative Group for Hairy Cell Leukemia . Leuk Lymphoma . 1994 ; 13 : 307 – 316 . 99 .[academic.oup.com]
Myopathy
  • NRTI therapy should be interrupted if drug-related myopathy is suspected, and discontinued if myopathy is diagnosed. References "Product Information. Tyzeka (telbivudine)." IDEC Pharmaceuticals Corporation, San Diego, CA. "Product Information.[drugs.com]

Workup

  • Often, the workup of new-onset pancytopenia is extensive and should include a detailed clinical, medication, recreational drug, and environmental exposure history.[academic.oup.com]
  • 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]

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]
  • Seite 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]
  • Other treatments Aplastic anemia caused by radiation and chemotherapy treatments for cancer usually improves once you complete those treatments. The same is true for most other drugs that induce aplastic anemia.[mayoclinic.org]
  • Fatigue can happen within days after a chemotherapy treatment and can last long after treatment ends. It also tends to be worse when you are having other treatments, such as radiation therapy. Fatigue usually gets better over time.[cancer.ca]

Prognosis

  • (Outcomes/Resolutions) The prognosis of Drug-Induced Thrombocytopenia is usually excellent, if the drug causing the condition is identified and discontinued, when possible In some, the prognosis may get complicated, if there is large amount of bleeding[dovemed.com]
  • 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]
  • Idiopathic myelofibrosis: an update with particular reference to clinical aspects and prognosis . Int J Clin Lab Res . 1993 ; 23 : 124 – 138 . 110 .[academic.oup.com]
  • Prognosis, response to therapy, and prevalence of antibody to the retrovirus associated with the acquired immunodeficiency syndrome. Ann Intern Med 1985;103:542-545. 36. Oksenhendler E, Bierling P, Farcet JP, et al.[hivinsite.ucsf.edu]

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]
  • Abstract New-onset pancytopenia can be caused by a wide variety of etiologies, leading to a diagnostic dilemma.[academic.oup.com]
  • 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]
  • 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]

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]
  • 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 [ 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]
  • 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]
  • PATHOPHYSIOLOGY Neutropenia is defined as having an absolute neutrophil count (ANC) of less than 500 cells/mm 3 and is a common adverse event associated with many cytotoxic chemotherapy agents. 8 During cytotoxic chemotherapy, neutropenia typically occurs[ptcommunity.com]
  • Myelodysplastic syndrome and aplastic anemia: distinct entities or diseases linked by a common pathophysiology? Semin Hematol . 2000 ; 37 : 15 – 29 . 97 . Leukemic reticuloendotheliosis . Blood . 1958 ; 13 : 609 – 630 . 98 .[academic.oup.com]

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]
  • Additionally, treatment measures including platelet transfusion, plasmapheresis, and corticosteroid medication may be required, in some cases of severe hemorrhage, to bring platelet count to normal range and prevent further bleeding episodes The prognosis[dovemed.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]

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