Last Updated on April 5, 2023 by Mike Robinson

Bone marrow diseases occur because of a problem in one of the cell types described. For example, white blood cells do not work well in leukemia (or white blood cell cancer).

The causes of these problems are different and include genetic and environmental factors.

Doctors perform blood and marrow tests to see if any marrow disease is present. Treatment depends on the type of disease and the severity of the disease, but it includes everything from medications to blood transfusions or bone marrow transplants.

The bone marrow is spongy and located inside some bones, such as the hip or thigh. This tissue contains stem cells that can develop into any blood cell.

1. The stem cells created by the marrow are transformed into red blood cells.
2. Red blood cells carry oxygen to white blood cells that are part of the immune system and fight against infections
3. Red blood cells also bring oxygen to platelets that plug wounds by clotting the blood.

Types of Bone Marrow Diseases

1- Leukemia

Leukemia is a type of cancer that occurs in white blood cells. As with all cancers, the disease occurs because too many cells are created in an uncontrolled manner.

White blood cells, called granulocytes or lymphocytes, develop in the bone marrow from stem cells. Leukemia occurs because stem cells cannot mature into white blood cells. Therefore they stay in an intermediate step called leukemia cells.

The leukemic cells do not degenerate, so they continue to grow and multiply uncontrollably, occupying the space of red blood cells and platelets. Therefore, these cells do not perform the function of white blood cells and, in addition, prevent the proper functioning of the rest of the blood cells.

The main symptoms suffered by leukemia patients are bruising and/or bleeding and the continuous feeling of being tired or weak.

In addition, they may suffer the following symptoms:

• Difficulty breathing.
• Pallor.
• Petechiae (flat spots under the skin caused by hemorrhages).
• Pain or feeling of fullness under the ribs on the left side.

The fewer the number of stem cells that have transformed into leukemic cells, the better the prognosis of this disease. Therefore, seeing a doctor and getting an early diagnosis if you feel some of the symptoms is important.

Treatment depends on the type of leukemia, age, and patient characteristics. Among the possible treatments are the following:

• Chemotherapy.
• Targeted therapy (molecularly).
• Radiotherapy.
• Transplant of stem cells or bone marrow.

2- Myelodysplastic syndromes 

Myelodysplastic syndromes (MDS) include a series of bone marrow diseases that affect the bone marrow and the blood. The main problem with these syndromes is that the bone marrow increasingly produces fewer blood cells, even stopping production altogether.

Patients suffering from MDS may suffer from the following:

• Anemia from low levels of red blood cells.
• Infections since they increase the odds due to low levels of white blood cells.
• Bleeding due to low levels of platelets.

There are several types of MDS; some are mild and can be treated easily, while others are more serious and can evolve into acute myelogenous leukemia.

Most people who suffer from bone marrow diseases like MDS are over 60 years old, although it can appear at any age. Some factors can increase the likelihood of suffering from this disease, such as exposure to industrial chemicals or radiation. In some cases, chemotherapy treatment for other diseases can cause MD.

The symptoms depend on the severity of the disease. In the beginning, you may feel no symptoms. Nevertheless, you can reveal this during a routine examination. That is why it is essential to have periodic check-ups.

The general symptoms are similar to leukemia and include tiredness, difficulty breathing, paleness, high infections, and bleeding.

Treatment usually begins with medications and chemotherapy, although a blood transfusion or a bone marrow transplant is necessary in many cases.

3- Myeloproliferative disorders

Myeloproliferative disorders are a varying group of diseases. They are characterized by the unusually high production of one or several types of blood cells (red blood cells, white blood cells, or platelets).

Patients suffering from these disorders are more likely to have thrombi and hemorrhage. In addition, they may end up developing acute leukemia due to the underlying disease and the treatment.

The symptoms and signs that patients with these disorders may suffer are the following:

• Tiredness and weakness
• Weight loss from anorexia or getting full early when eating. This symptom becomes more evident if they have chronic myelogenous leukemia or agnogenic myeloid metaplasia.
• Bruising, bleeding, or thrombi.
• Inflammation and joint pain.
• Priapism, tinnitus or stupor of leukostasis.
• Petechiae (tiny purple, red, or brown spots on the skin).
• Spleen and/or palpable liver.
• Acute febrile neutrophilic dermatosis or Sweet syndrome (fever and painful lesions in the trunk, arms, legs, and face).

4- Aplastic anemia

Aplastic anemia is a rare blood disease that can be very dangerous. The bone marrow of people suffering from aplastic anemia cannot produce enough blood cells.

This bone marrow disease occurs because the stem cells of the bone marrow are damaged. Several factors can affect stem cells. In addition, these conditions can be hereditary, although you may not find the cause in many cases.

Among the acquired causes, we can find the following:

• Intoxication with substances such as pesticides, arsenic, or benzene.
• Receive radiotherapy or chemotherapy.
• Take certain medications
• Suffer some infections such as hepatitis, Epstein-Barr virus, or HIV.
• Suffer an autoimmune disease.
• Be pregnant.

This disorder is progressive, meaning the symptoms get worse over time. Early in the disease, people diagnosed with aplastic anemia suffer symptoms like fatigue, weakness, dizziness, and breathing difficulties. They may have heart problems such as arrhythmia or heart failure in more severe cases. Additionally, they can suffer infections and frequent bleeding.

A person’s personal and family history may be important when diagnosing this disease. A medical examination and some tests, such as blood tests, are usually necessary.

Although treatments for this bone marrow disease are specific for each person, they usually include blood transfusions, bone marrow transplants, and/or medicines.

5- Iron deficiency anemia

Iron deficiency anemia occurs when the levels of red blood cells are very low or do not work well. This type of anemia is the most common. The disease prevents the cells of our body from receiving enough iron through the blood.

The body uses iron to make hemoglobin, a protein responsible for transporting oxygen through the bloodstream. Without this protein, the organs and muscles do not receive enough oxygen, which prevents them from burning the nutrients for energy and, therefore, can not function efficiently. In short, the lack of iron in the blood causes the muscles and organs not to work correctly.

Like many bone marrow diseases, people who suffer from anemia do not even realize they have a problem. Women are more at risk of having this type of anemia due to blood loss during menstruation or pregnancy.

This disease can also occur because the person does not take enough iron in their diet, as well as some intestinal diseases that cause problems absorbing iron.

Treatment depends on the cause of the anemia, but it usually includes a change in diet and iron supplements.

6- Plasma cell neoplasia

Plasma cell neoplasia disease happens when the bone marrow makes too many cells of this type. Plasma cells develop from B lymphocytes, which mature from stem cells.

When an external agent (such as a virus or bacteria) enters our body, lymphocytes often become plasma cells, which create antibodies to fight infections.

The problem for people suffering from these disorders is that their plasma cells are damaged and divide uncontrollably. These damaged plasma cells are called myeloma cells.

In addition, the myeloma cells give strength to a protein that has no beneficial use and does not act against infections, the M protein. The high density of these proteins causes the blood to thicken. In addition, as they are useless, our body is continuously discarding them, causing potential kidney problems.

The continuous reproduction of plasma cells causes tumors, which may be benign or develop into cancer.

Neoplasms include the following conditions:

• Monoclonal gammopathy of uncertain significance (MGUS). This pathology is mild because abnormal cells represent less than 10% of blood cells and do not usually develop cancer. In most cases, patients do not notice any signs or symptoms. Although in some cases can result in problems with the nervous system, heart, or kidney.
• Plasmocytoma In this disease, abnormal cells (myelomas) stored in the same place create a single tumor called plasmacytoma. There are two types of plasmacytomas:
  • Plasmacytoma of bone. In this type of plasmacytoma, the tumor is around a bone. Patients do not usually notice other symptoms other than the tumor itself. Other symptoms include fragility in the bones and localized pain. In some cases, it may worsen over time, and multiple myeloma may develop.
  • Extramedullary plasmacytoma. These tumors are not located in a bone. Instead, you find them in soft tissue such as the throat, the amygdala, or the paranasal sinuses. The symptoms suffered by patients with this type of plasmacytoma depend on the tumor’s exact location. For example, a plasmacytoma in the throat can cause difficulty swallowing.
• Multiple myeloma. This is the most serious type of neoplasm since the uncontrolled production of myelomas produces numerous tumors that can affect the bone marrow, causing it to produce fewer blood cells (red blood cells, white cells, or platelets). Sometimes, you do not feel symptoms at the beginning of the disease. Therefore it is recommended to have blood and urine tests periodically if you suffer any of these symptoms:
  • Pain located in the bones.
  • Fragile bones
  • Fever without a known cause or frequent infections.
  • Easy to bruise or bleed.
  • Difficulty breathing
  • Weakness in the extremities.
  • Feeling extreme fatigue continuously.

Also Read: Batten’s Disease: Symptoms, Causes, Treatment

If the tumors are in the bones, they can cause hypercalcemia, that is, too much calcium in the blood. This condition can cause serious problems such as loss of appetite, nausea, vomiting, thirst, frequent urination, constipation, fatigue, muscle weakness, confusion, or difficulty concentrating.