Panmyelopathy or bone marrow aplasia

The name panmyelopathy is also known as bone marrow aplasia or aplastic anemia. It is a disease of the bone marrow that causes a decline in the production of white and red blood cells. This causes, among other things, anemia. There are two forms of this disease. The disease is very rare, but once you have it you cannot get rid of it easily. Fortunately, treatment is possible but may not always be sufficient. In this article, bone marrow aplasia will be chosen because of the three different names.

What is bone marrow aplasia or panmyelopathy?

Bone marrow aplasia sounds unfamiliar to many people. That may be true, because this disease is very rare. 1 in 400,00 to 500,000 people develop this disease. However, the disease is more common in the temporary form in people exposed to certain medications and sometimes during pregnancy. Sometimes the disease is caused by a viral infection. In this disease, the bone marrow is damaged or diseased to such an extent that it shows a relapse in the production of red blood cells, white blood cells and platelets.

Antibiotics and other medications

Bone marrow aplasia sometimes caused deaths around 1960-1970 due to the use of a certain type of antibiotic: chloramphenicol. It is a broad-spectrum antibiotic that is still used but was very popular at the time because of its low price. Bone marrow aplasia can also occur when using a cytostatic drug, a form of chemotherapy. The drug procainamide, which is sometimes prescribed for atrial fibrillation, among other things, is also a causative agent. Bone marrow aplasia is usually temporary when using these medications and disappears after discontinuation. Although deaths used to occur due to the use of chloramphenicol, this risk is now virtually eliminated due to better medical guidance. The function of the bone marrow is also closely monitored during certain chemotherapy treatments.

X-ray and radioactive radiation

People who have been exposed to high doses of X-rays or radioactive radiation have an increased risk of bone marrow aplasia. Nowadays, less and less X-rays are used for X-rays due to improved equipment, but cancer treatment uses fairly high doses of X-rays. Exposure to radioactive radiation through inhaling contaminated air or eating contaminated food also increases the risk. Nuclear disasters release a lot of radioactive radiation, which is very harmful to health.


An initial phenomenon is one of the typical symptoms of anemia. This is because anemia actually occurs: There is too low a level of hemoglobin in the blood, which binds to oxygen. Anemia is a consequence of bone marrow aplasia, so anemia does not cause bone marrow aplasia. The following symptoms occur with bone marrow aplasia:

  • Fatigue
  • Faster bleeding, bleeding that is difficult to stop, bleeding gums
  • Rapid heart rate or irregular heartbeat
  • Shortness of breath or tightness
  • Pinpoint bleeding under the skin and unexplained bruising
  • Pale skin, discoloration of the lips and mucous membranes (blue)
  • Headache and dizziness
  • Cold extremities (hands, feet)

Not all symptoms need to occur simultaneously. In addition, having these symptoms is not always due to bone marrow aplasia. Other diseases can also cause these symptoms. Extensive research will be required for the diagnosis. Examination consists of blood tests to determine whether there are sufficient red and white blood cells in the blood. The bone marrow is examined by means of a bone marrow puncture.

Treatment and recovery

It is important to prevent infections in bone marrow aplasia because the immune system is greatly reduced. Medicines can be prescribed with the function of preventing inflammation. A blood transfusion is sometimes necessary. Another method is to administer antithymocyte globulin, a purified animal protein from horses or rabbits. The horse or rabbit is injected with blood from the patient, after which it produces antibodies against it. The blood containing the antibodies is then taken from the animal, processed and injected back into the patient. The antibodies destroy the T-lymphocytes, which are responsible for the breakdown of your own stem cells. A complicated process, but this method works for most patients. However, caution is required: during this treatment the body’s own defenses drop very sharply.
Sometimes treatment with male sex hormones is chosen. This can stimulate the production of blood sheets. In severe cases, a bone marrow transplant or stem cell transplant is chosen.
If the disease is temporary due to medicines or otherwise, the cause can be addressed and the treatment of bone marrow aplasia will be much quicker. If the cause is not found or if action is taken too late, this disease can be fatal. Persistent complaints as described above should always be checked by a doctor.

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