Myelosuppressio

Myelosuppressio is not a standard medical term; in English, the condition is usually referred to as myelosuppression. Myelosuppression denotes a reduction in bone marrow activity with decreased production of blood cells, including red blood cells, white blood cells, and platelets. The severity can range from mild to life-threatening and may be temporary or persistent, depending on the underlying cause.

Causes are diverse. It commonly occurs as a side effect of cytotoxic chemotherapy and radiotherapy, but it can also result from bone marrow disorders such as aplastic anemia or myelodysplastic syndromes, viral infections, autoimmune diseases, and exposure to certain drugs or toxins. In some cases, the suppression reflects an underlying hematologic disease rather than a treatment effect.

Pathophysiology involves impaired hematopoietic stem cell function and disruption of the marrow microenvironment, leading to cytopenias: anemia (low red cells), neutropenia or leukopenia (low white cells, with increased infection risk), and thrombocytopenia (low platelets, with bleeding risk). The combination of these deficits increases vulnerability to fatigue, infections, and bleeding.

Clinical features mirror the cytopenias. Anemia causes fatigue and pallor; leukopenia raises infection risk and may present with fever; thrombocytopenia increases bruising, petechiae, and mucosal bleeding. Diagnosis relies on blood tests showing cytopenias, with peripheral smear and reticulocyte count guiding interpretation; bone marrow examination may be needed to assess marrow cellularity and architecture.

Management is cause-specific and often includes supportive care: infection surveillance and antibiotics as needed, growth factors (such as G-CSF) to stimulate white cell production, transfusions for symptomatic anemia or severe bleeding risk, and dose modifications of the offending treatment. In selected cases, stem cell transplantation or disease-specific therapies may be indicated.