Bone Marrow Failure (BMF)
Bone Marrow Failure (BMF): Overview, Causes, Symptoms, and Management
What is Bone Marrow Failure?
Bone marrow failure (BMF) is a condition in which the bone marrow cannot produce adequate amounts of one or more types of blood cells-red blood cells, white blood cells, or platelets. This results in anemia, increased risk of infection, and bleeding or bruising due to low platelets126.
Types and Causes
BMF can be inherited (genetic) or acquired (developing later in life):
Inherited BMF Syndromes
- Fanconi anemia
- Dyskeratosis congenita
- Shwachman-Diamond syndrome
- Congenital amegakaryocytic thrombocytopenia
- Blackfan-Diamond anemia
- Reticular dysgenesis
These syndromes often present in childhood and may be associated with other physical abnormalities or increased cancer risk56.
Acquired BMF
- Aplastic anemia (often autoimmune)
- Myelodysplastic syndrome
- Medications (chemotherapy, certain antibiotics, NSAIDs, anti-thyroid drugs, etc.)
- Toxins (benzene, radiation)
- Malignancies (leukemia, lymphoma, myeloma)
- Viral infections (hepatitis B, Epstein-Barr virus, parvovirus B19)
- Vitamin B12 or folate deficiency256
Acquired BMF is more common in adults, while inherited forms are more frequent in children6.
Symptoms
- Bleeding and bruising: Due to low platelets; may see bleeding from gums, nose, skin, or in urine/stool12.
- Fatigue and pallor: From anemia (low red blood cells)125.
- Frequent infections: Due to low white blood cells125.
- Other signs: Shortness of breath, tooth loss/decay, chronic fatigue, fever, mucosal ulcers, and, in children, possible developmental abnormalities25.
Diagnosis
- Clinical evaluation: History, physical exam, and assessment of symptoms5.
- Laboratory tests: Complete blood count (CBC), bone marrow biopsy, genetic testing for inherited forms45.
- Additional tests: Rule out vitamin deficiencies, infections, and secondary causes46.
Treatment
- Supportive care: Blood transfusions (red cells, platelets), antibiotics for infections135.
- Definitive therapy:
- Hematopoietic stem cell transplant (HSCT): Only curative option for many forms, especially inherited BMF15.
- Immunosuppressive therapy: For acquired aplastic anemia (not effective in inherited forms)5.
- Medications: Steroids for specific conditions (e.g., Blackfan-Diamond anemia), iron chelators for transfusion-related iron overload5.
- Other: Infection prophylaxis, genetic counseling, monitoring for secondary cancers56.
Prognosis
- Inherited BMF: Prognosis depends on the specific syndrome, age at transplant, and response to therapy. Risk of secondary cancers and complications from cytopenias remains high5.
- Acquired BMF: Varies with cause and response to treatment; some forms are reversible, others require lifelong management15.
Key Points
- BMF results in low blood cell counts, causing bleeding, infections, and fatigue.
- Can be inherited (genetic syndromes) or acquired (autoimmune, drugs, toxins, etc.).
- Diagnosis relies on blood tests, bone marrow biopsy, and sometimes genetic analysis.
- Treatment includes supportive care and, when possible, stem cell transplantation.
- Lifelong monitoring is often required due to risk of complications and secondary cancers.
Consult with Our Team of Experts Now!
At DrStemCellsThailand (DRSCT)‘s Anti-Aging and Regenerative Medicine Center of Thailand, we emphasize comprehensive evaluations and personalized treatment plans of Cellular Therapy and Stem Cells for managing various health conditions. If you have questions about Bone Marrow Failure (BMF) or would like more information on our services, consult with our experts today!
Consult with Our Team of Experts Now!
References:
1 Cleveland Clinic
2 Wikipedia
3 Dana-Farber
5 StatPearls (NCBI Bookshelf)
6 Patient.info
