Editing Bone marrow suppression (section)

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'''Bone marrow suppression''' also known as '''myelotoxicity''' or '''myelosuppression''', is the decrease in production of cells responsible for providing immunity ([[leukocytes]]), carrying oxygen ([[erythrocytes]]), and/or those responsible for normal blood clotting ([[thrombocytes]]).<ref>{{cite web
|url=http://medical-dictionary.thefreedictionary.com/bone+marrow+suppression|title=bone marrow suppression|access-date=3 May 2011}}</ref> [[Bone marrow]] suppression is a serious [[side effect]] of [[chemotherapy]] and certain drugs affecting the [[immune system]] such as [[azathioprine]].<ref>[http://www.marvistavet.com/html/body_azathioprine.html Azathioprine side effects] {{webarchive |url=https://web.archive.org/web/20101125155614/http://www.marvistavet.com/html/body_azathioprine.html|date=November 25, 2010}}</ref> The risk is especially high in cytotoxic chemotherapy for [[leukemia]]. In the case of [[non-small-cell lung cancer]], myelosuppression predisposition was shown to be modulated by [[Enhancer (genetics)|enhancer]] mutations.<ref>{{Cite journal |last1=Zhigulev |first1=Artemy |last2=Norberg |first2=Zandra |last3=Cordier |first3=Julie |last4=Spalinskas |first4=Rapolas |last5=Bassereh |first5=Hassan |last6=Björn |first6=Niclas |last7=Pradhananga |first7=Sailendra |last8=Gréen |first8=Henrik |last9=Sahlén |first9=Pelin |date=March 2024 |title=Enhancer mutations modulate the severity of chemotherapy-induced myelosuppression |journal=Life Science Alliance |volume=7 |issue=3 |pages=e202302244 |doi=10.26508/lsa.202302244 |issn=2575-1077 |pmc=10796589 |pmid=38228368}}</ref>

[[Nonsteroidal anti-inflammatory drug]]s (NSAIDs), in some rare instances, may also cause bone marrow suppression. The decrease in blood cell counts does not occur right at the start of chemotherapy because the drugs do not destroy the cells already in the bloodstream (these are not dividing rapidly). Instead, the drugs affect new blood cells that are being made by the bone marrow.<ref>[http://www.cancer.org/Treatment/TreatmentsandSideEffects/TreatmentTypes/Chemotherapy/ChemotherapyPrinciplesAnIn-depthDiscussionoftheTechniquesanditsRoleinTreatment/chemotherapy-principles-chemo-side-effects-bone-marrow-suppression Bone marrow suppression]</ref> When myelosuppression is severe, it is called myeloablation.<ref>[http://www.cancer.gov/dictionary/?CdrID=44173 Dictionary of Cancer Terms: myelosuppression ]</ref>

Many other drugs including common antibiotics may cause bone marrow suppression. Unlike chemotherapy the effects may not be due to direct destruction of stem cells but the results may be equally serious. The treatment may mirror that of chemotherapy-induced myelosuppression or may be to change to an alternate drug or to temporarily suspend treatment.

Because the bone marrow is the manufacturing center of blood cells, the suppression of bone marrow activity causes a deficiency of blood cells. This condition can rapidly lead to life-threatening [[infection]], as the body cannot produce [[leukocytes]] in response to invading [[bacteria]] and [[viruses]], as well as leading to [[anaemia]] due to a lack of [[red blood cells]] and spontaneous severe bleeding due to deficiency of [[platelets]].

[[Parvovirus B19]] inhibits [[erythropoiesis]] by lytically infecting RBC precursors in the bone marrow and is associated with a number of different diseases ranging from benign to severe. In [[immunocompromised]] patients, B19 infection may persist for months, leading to chronic [[anemia]] with B19 viremia due to chronic marrow suppression.<ref>[http://www.wrongdiagnosis.com/h/human_parvovirus_b19_infection/book-diseases-20a.htm Parvovirus B19 - BASICS]</ref>