A wide variety of conditions can be diagnosed by examination
of the bone marrow. The following examples illustrate some of the
most frequent conditions, but there are many more. The presence or
absence of cancer in the bone marrow can determine what treatments
are recommended to a patient with cancer known to be elsewhere in the body. Some
cancers (leukemia, multiple myeloma) arise from cells in the marrow
so this is where the biopsy must be taken to confirm the diagnosis. A
low blood-clotting element (platelet count) in the blood
(thrombocytopenia) can be due to several causes. It is important to
establish whether or not the cells that make the platelets
(megakaryocytes) are still present in the marrow (idiopathic
thrombocytopenic purpura) or are gone (aplastic anemia). Most cases
of anemia (low red blood cells) can be diagnosed by simple blood
tests. When these tests are negative, examining the marrow can
reveal problems with the red blood cells that are uncommon
causes of anemia (sideroblastic anemia, aplastic anemia). Persistent
fevers can be caused by infections that reside in the marrow
(atypical mycobacteria, brucellosis) and a sample of the marrow may
provide the best source of culture material.
Different individuals feel the pain caused by injection of the
local anesthetic and the remainder of the procedure to a variable
extent. There may be dull soreness for a day or two. Significant
complications are very unusual but can include bleeding, infection,
and prolonged pain. Rare fatalities have been reported, usually
during sternal marrows when the needle has penetrated the sternum and
cut one of the arteries on the surface of the heart.
Leukemia is a type of cancer of the blood cells in which the growth and development of the blood cells are abnormal. Strictly speaking, leukemia should refer only to cancer of the white blood cells (the leukocytes) but in practice it can apply to malignancy of any cellular element in the blood or bone marrow, as in red cell leukemia (erythroleukemia).
Anemia is the condition of having less than the normal number of red blood cells or less than the normal quantity of hemoglobin in the blood. The oxygen-carrying capacity of the blood is, therefore, decreased.
In the U.S., more than 2,000 people are diagnosed with bone cancer every year. There are many types of bone cancer. The most common forms of bone cancer are osteosarcoma, Ewing's sarcoma, chondrosarcoma, malignant fibrous histiocytoma, fibrosarcoma, and chordoma. Pain is the most common symptom. Treatment usually involves surgery, chemotherapy, and radiation therapy.
Non-Hodgkin's lymphoma is cancer of the lymphatic system, a vital part of the body's immune system. Symptoms include swollen lymph nodes, fever, night sweats, coughing, weakness, chest pain, unexplained weight loss, and abdominal pain. Treatment depends on which type of non-Hodgkin's lymphoma you have, the stage of the cancer, your age, how fast the cancer is growing, and whether you have other health problems.
Multiple myeloma is a form of cancer that develops in plasma cells, the white blood cells that make antibodies. Symptoms include bone pain, weakness, extreme thirst, nausea, frequent urination, and broken bones. Treatment of multiple myeloma depends upon the staging and symptoms of the disease.
Hodgkin's disease is a cancer of the lymphatic system with symptoms that include unexplained, recurring fevers, unexplained weight loss, itchy skin, and painless swelling of the lymph nodes in the neck, underarm, and groin. Treatment for adult Hodgkin's disease depends on the staging of the disease, the lymph nodes' size, and the health of the patient.
Neutropenia is a marked decrease in the number of neutrophils, neutrophils being a type of white blood cell (specifically a form of granulocyte) filled with neutrally-staning granules, tiny sacs of enzymes that help the cell to kill and digest microorganisms it has engulfed by phagocytosis.
Alpha thalassemia is a disorder in which the alpha globin protein is underproduced. There are two pairs of genes that carry the code for the alpha chains of hemoglobin. When one gene is impaired, that person is in a carrier state and suffers no medical problems. When four genes are impaired, the production of fetal and adult hemoglobin is prevented, resulting in hydrops fetalis and leading to death before birth.
Neuroblastoma is a type of cancer that usually afflicts children under 5 years of age. The cancer forms in the adrenal glands, neck, chest, or spinal cord. Symptoms include bulging eyes, bone pain, dark eye circles, a lump in the neck, chest, or abdomen, weakness, or swollen stomach. Treatment depends upon the risk group, which is determined by staging, the child's age, tumor histology, and the tumor biology.
Stem cells are referred to as undifferentiated cells due to the fact that they have not yet committed to a developmental path to form specific organ tissue. There are a variety of types of stem cells to include embryonic, fetal, adult peripheral blood, umbilical cord, and induced pluripotent stem cells.
Childhood acute lymphoblastic leukemia is the most common type of cancer in children. Symptoms and signs include fever, easy bruising, bone or joint pain, weakness, loss of appetite, and painless lumps in the neck, underarm, stomach, or groin. Treatment depends upon staging and may include chemotherapy, radiation, or stem cell transplant.
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