Bone marrow hematopoietic dysfunction

Everyone knows that bone marrow has the function of hematopoiesis, and whether the hematopoietic function is normal directly reflects the health of the human body. If the human body's bone marrow hematopoietic function is abnormal, there may be serious illness or even leukemia. Therefore, many patients are very worried when they find that their report shows abnormal hematopoietic function. Experts suggest that it is best to actively cooperate with the doctor for diagnosis and treatment at this time, and never take it lightly and affect the condition.

What is Bone Marrow

The bone marrow is a spongy tissue that exists in the medullary cavity of long bones (such as humerus and femur) and the mesh between the loose bone of flat bones (such as ilium). The bone marrow that can produce blood cells is slightly red and is called red bone marrow. When a person is born, red bone marrow fills the bone marrow cavities throughout the body. As age increases, the number of fat cells increases, and a considerable portion of the red bone marrow is replaced by yellow bone marrow. Finally, almost only the bone marrow cavities of flat bones contain red bone marrow. This change may be because adults do not need all of the bone marrow cavity hematopoiesis, and partial bone marrow cavity hematopoiesis is sufficient to replenish the required blood cells. When the body is severely ischemic, part of the yellow bone marrow can be replaced by red bone marrow, and the hematopoietic capacity of the bone marrow is significantly improved.

Bone marrow hematopoiesis

Hematopoietic stem cells in the bone marrow are composed of hematopoietic stem cells that differentiate into cells of various lineages and different stages. Hematopoietic stem cells are the core of the hematopoietic system. Under normal circumstances, they produce red blood cells, white blood cells, platelets, etc. at a certain speed and proportion. It can also rapidly differentiate and mature into different cells according to the needs of the body. For example, if a patient loses blood and needs a large number of red blood cells, it can rapidly differentiate into red blood cells and produce a large number of red blood cells. Hematological system tumors are often caused by abnormalities in a certain stage of hematopoietic stem cell or reticular differentiation and growth. Not only can the disease itself cause some adverse consequences, but it also often affects the normal hematopoietic process.

Hematopoiesis: Red blood cells, granulocytes, platelets and B lymphocytes in adults are all produced by the bone marrow, with a certain amount produced every day. Under special circumstances, the bone marrow can speed up the production of certain cells based on the body's needs. For example, red blood cells are produced rapidly and in large quantities when there is blood loss, and granulocytes are produced in large quantities when there is bacterial infection.

Defensive function: Macrophages in the bone marrow can engulf bacteria and toxins, erecting a barrier of defense for the body. Macrophages can also remove aging red blood cells, and the iron in them is stored by macrophages and waits for the body to reuse.

Immune function: The bone marrow is the production site of B lymphocytes and provides hematopoietic stem cells to the thymus, where they develop into T lymphocytes. B lymphocytes and T lymphocytes are the most important cells that make up the body's defense against disease. In addition, there are plasma cells in the bone marrow that can secrete immunoglobulins and are also an important barrier to the body's defense.

Diagnosis of bone marrow hematopoietic dysfunction

(1) Nutritional factors, poisoning or other causes can cause changes in pathological hematopoiesis, including Vit

B12 and FA deficiency, deficiency of essential elements for the human body and exposure to heavy metals, especially arsenic and some other commonly used drugs and biological reagents.

(2) Congenital blood system diseases, such as congenital dyserythropoietic anemia (CDA), can cause dyserythropoiesis of the erythroid system. Parvovirus B19 infection can cause a decrease in immature red blood cells, accompanied by giant megaloblastic immature red blood cells. The immunosuppressant mycophenolate mofetil can also cause a decrease in immature red blood cells.

(3) Drug factors: Co-trimoxazole can lead to a decrease in neutrophil nuclear lobation, which can easily be confused with the dysplastic hematopoiesis in MDS. Chemotherapy can cause significant myeloid cell dysplasia. G-CSF can cause changes in the morphology of neutrophils, such as a significant increase in cytoplasmic granules and a decrease in nuclear lobes; primitive cells can be seen in the peripheral blood, but rarely exceed 10%. The proportion of primitive cells in the bone marrow is generally normal, but can also be elevated.

It is important to understand the clinical history, including exposure to drugs and chemical agents, and to consider nonclonal disorders when differentiating myelodysplasia, especially in cases with low levels of blasts. If the diagnosis is difficult, bone marrow and cytogenetic examinations can be performed again after a few months.