What are symptoms of myelosuppression?
Myelosuppression symptoms may vary depending on how it affects your blood cells and platelets. Your red blood cells, white blood cells and platelets support your body in different ways. When your bone marrow doesn’t make enough red blood cells or platelets, you may develop certain blood disorders such as anemia or thrombocytopenia. If your white blood cell levels are low, you may have an increased risk of infection.
Anemia
Anemia happens when you don’t have enough red blood cells. Your red blood cells carry oxygen throughout your body. Anemia symptoms include:
- Fatigue.
- Shortness of breath (dyspnea).
- Dizziness.
- Fast or irregular heartbeat (arrhythmia).
- Pounding or “whooshing” sound in your ear (pulsatile tinnitus).
- Headache.
- Skin color that’s more pale than usual.
- Chest pain.
Neutropenia
Myelosuppression may keep your bone marrow from making enough neutrophils, a white blood cell that destroys germs that cause infections. People with lower-than-normal neutrophil levels have neutropenia. Neutropenia doesn’t cause symptoms, but the infections that may result from having neutropenia can. Repeated infections may also be a sign of neutropenia. Symptoms of infection may include:
- Fever (febrile neutropenia).
- Fatigue.
- Sore throat (pharyngitis).
- Swollen lymph nodes.
- Ulcers in your mouth or around your anus.
- Diarrhea.
- A burning sensation when you pee, feeling as if you need to pee right away or need to pee more often than usual.
Thrombocytopenia
Platelets help control bleeding. People with low platelet levels have thrombocytopenia. Thrombocytopenia symptoms include:
- A cut or a nosebleed that won’t stop bleeding.
- Bruises that happen more frequently than usual.
- Petechiae, which may look like a rash on your lower legs.
- Purpura, which may look like red, purple or brown spots on your skin.
Pancytopenia
When blood cell and platelet levels are all low, you have pancytopenia. Like neutropenia, pancytopenia isn’t a disease but it may be a sign of underlying conditions.
What causes myelosuppression?
Chemotherapy to treat cancer is the most common cause. But some blood cancers and certain viruses can affect your bone marrow and cause myelosuppression.
Chemotherapy, immunotherapy and myelosuppression
Several chemotherapies may cause myelosuppression, but the most common include:
CAR T-cell therapy, which is a type of immunotherapy, may affect your bone marrow so it produces fewer blood cells and platelets.
Blood cancers and myelosuppression
Blood cancers can interrupt normal blood cell production. In blood cancers such as leukemia, lymphoma and myeloma, abnormal blood cells multiply in your bone marrow and keep it from producing healthy blood cells and platelets.
Viruses and myelosuppression
Viruses may cause myelosuppression by disrupting the blood cell production process. Your body fights intruders, including viruses, by rallying white blood cells that destroy intruders. When that happens, your bone marrow may make fewer red blood cells and platelets. Some research suggests certain viruses may infect blood-forming cells in your bone marrow and lower blood cell levels. Experts have linked the following viruses to myelosuppression:
- Epstein-Barr virus (EBV).
- Hepatitis C virus.
- Parvovirus 19.
- Cytomegalovirus (CMV).
- Chickenpox (varicella zoster).
- Human immunodeficiency virus (HIV).
- Dengue fever.
What are the complications of myelosuppression?
Myelosuppression may cause life-threatening complications such as acute anemia or uncontrollable bleeding.
