Our bone marrow produces stem cells that mature into red blood cells (200 billion every day), white blood cells (up to 100 billion), and platelets (400 billion). Below, we’ll delve into each, describing their role and what can go wrong, along with symptoms and treatment. (Also, click here to read our post When Do You Need a Bone Marrow Test?)

Red Blood Cells

Bone marrow produces stem cells that can become red blood cells, whose job is to distribute oxygen and carbon dioxide to the body’s cells, tissues, and organs. They have a life expectancy of between 100 and 120 days, and they become less active and more fragile with age. About 1 percent of the body’s red blood cells are removed every day by a type of white blood cell.

• What can go wrong: Perhaps the most common red blood cell disorder is anemia, and there are five different types—iron deficiency, pernicious (B12 deficiency), aplastic (not enough red blood cells), autoimmune hemolytic (overactive immune system), and sickle cell anemia (red blood cells stick together).
• Symptoms, plus examples of treatments (see chart): Fatigue, weakness, pale or yellowish skin, shortness of breath, dizziness, irregular heartbeat, chest pain, headache, cold hands/feet.
  

  Condition	Treatment
  Iron deficiency	Iron supplements
  Pernicious anemia	High-dose B12 supplements
  Aplastic anemia	Transfusions, bone marrow transplant
  Autoimmune hemolytic anemia	Immune suppressants (e.g., prednisone)
  Sickle cell anemia	Blood transfusions, pain meds, bone marrow transplant

White Blood Cells

Five different kinds of white blood cells are produced by bone marrow to fight infections and outside forces like smoke and dust. When you have an infection, the number of white blood cells increases significantly. White blood cells make up only 1 percent of our blood, and a drop of blood contains between 7,000 and 25,000 white blood cells. Think of them as your bodyguards who have a lifespan of only one to three days.

• What can go wrong: Although it can start in other types of blood cells, leukemia is a cancer in which the cells are abnormal. They don’t die when they should, and they may crowd normal white cells out. Two forms of leukemia are acute; four are chronic. The ones more common in older adults are acute myeloid leukemia, chronic lymphoid leukemia, and chronic myelomonocytic leukemia.
• Symptoms, plus examples of treatments (see chart): Fever, chills, fatigue, infections, lost weight, swollen lymph nodes, bleeding/bruising, nosebleeds, bone pain/tenderness.
  

  Condition	Treatment
  Acute myeloid leukemia	Chemotherapy, targeted drug therapy, stem cell transplant
  Chronic lymphoid leukemia	Chemotherapy, rituximab, bendamustine, ibrutinib, alemtuzumab with rituximab
  Chronic myelomonocyctic leukemia	Azacytidine, decitabine, hydroxyurea, stem cell transplant, transfusions, antibiotics

Platelets

We need platelets to help blood clot and stop bleeding. A normal platelet count is 150,000 to 450,000 per microliter of blood. The risk for spontaneous bleeding develops if a platelet count falls below 10,000 to 20,000. Each platelet has a lifespan of seven days. When a blood vessel is damaged, it sends a message that is picked up by platelets, which rush to the affected area and repair it.

• What can go wrong: The answer here may be not enough platelets, too many platelets, or platelets that don’t clot as they should. In a condition called thrombocytopenia, the bone marrow makes too few platelets. It can be caused by certain medications, cancer, kidney disease, pregnancy, infections, and a malfunctioning immune system. When bone marrow produces too many platelets, it’s called thrombocythemia. It can result in blood clots that block the flow of blood to the brain or heart. The cause is unknown.Thrombocytosis is also caused by too many platelets, but the count is not as high as in thrombocytopenia. It’s caused by another disease or condition that stimulates the bone marrow to make more platelets.

  In some cases, the problem is simply platelet dysfunction. It is caused by diseases (kidney disease, Lupus, multiple myeloma), infection, or certain drugs (aspirin, NSAIDS, other antiplatelet medications).

• Symptoms, plus example of treatments (see chart): Easy bruising, hard-to-stop bleeding, blood in stools/urine, fatigue, heavy menstrual flows, yellowish skin.
  

  Condition	Treatment
  Thrombocytopenia	Change in medications, blood/platelet transfusions, corticosteroids, splenectomy
  Thrombocythemia	Observation, hydroxyurea, anagrelide, interferon
  Thrombocytosis	Low-dose aspirin, hydroxyurea, anagrelide, interferon, plateletpherisis

Other Cancers That Affect Bone Marrow

Multiple myeloma occurs in plasma cells that originate in bone marrow. They make antibodies that guard against bacteria. People who have multiple myeloma have plasma cells that don’t reproduce normally. Instead, they become cancerous, divide, and grow out of control, often appearing in several places in the body. The cause is unknown. Bone damage is the primary effect of the disease.

Multiple myeloma is treated by chemotherapy, stem cell transplant, radiation, and surgery.

Lymphomas are cancer cells in the lymphatic system that can develop in multiple locations, including in bone marrow. You’ll recognize them by their names—non-Hodgkin lymphoma and Hodgkin lymphoma. Both affect white blood cells, the only difference being a specific type of cell present in Hodgkin’s lymphoma.

Lymphomas are not preventable, but survival rates with treatment are good. It includes biologic therapy (drugs that trigger the immune system to attack cancer cells), antibody therapy (to counteract antigens), chemotherapy and radiation (to kill cells), steroids, and surgery.

Bone Marrow: Life-Giving, But Vulnerable

Bone marrow is life-giving and essential, but also vulnerable and at times malfunctioning. Getting regularly scheduled physical exams that include blood tests is the best way to guard against and get early treatment for bone marrow disorders.

The post What Is Bone Marrow? We Dig In on This Efficient Producer of Stem Cells appeared first on University Health News.

In general terms, leukemia is cancer of your body’s blood-forming tissues, such as the bone marrow. Signs of leukemia vary, depending on the type of cancer you have; in some cases, leukemia causes no symptoms early on.

Since many leukemia symptoms are vague and may be caused by other conditions—cancerous and non-cancerous—it’s important to have them evaluated by your physician. A prompt, accurate diagnosis means an earlier start to treatment that may save your life.

What Is Leukemia?

Leukemia results in overproduction of cancerous white blood cells that don’t function properly. Eventually, leukemia cells crowd out and inhibit the formation of normal red blood cells, platelets, and healthy white blood cells, which fight infection.

Acute forms of leukemia include two main subtypes: acute lymphocytic leukemia and acute myeloid leukemia. The acute forms progress more rapidly and, left untreated, can result in death in weeks or months. However, some acute leukemias may respond more favorably to treatment and, in many cases, can be cured.

Chronic leukemias tend to advance more slowly and may not cause problems until later stages—oftentimes, patients can live for many years—but they tend to be more difficult to cure than acute forms. The two main subtypes are chronic lymphocytic leukemia and chronic myeloid leukemia.

Know the Signs: Common Leukemia Symptoms

Leukemia symptoms vary depending on whether you have an acute or chronic form of the disease. Early acute leukemia symptoms may resemble those of the flu, and include fever, achy joints, fatigue, and swollen lymph glands.

As acute leukemia progresses and platelet production wanes, clotting problems may develop, causing easier bruising or bleeding, or the formation of tiny red spots on the skin known as petechiae. Declines in healthy white blood cells may reduce your ability to fight infections.

Many people with chronic leukemias, particularly those in the early stages, have no symptoms and are diagnosed incidentally on the basis of an elevated white blood cell count on blood tests performed for another reason. Chronic lymphocytic leukemia symptoms include fever, dizziness, fatigue, infections, excessive sweating, night sweats, swollen lymph glands, loss of appetite and related weight loss, and excessive bruising and bleeding.

Chronic myeloid leukemia symptoms include fever, fatigue, night sweats, weight loss, and bone pain. Also, patients with either form of chronic leukemia may develop a sense of fullness in the belly, even after eating little food, as well as pain or pressure in the upper left side of the abdomen caused by an enlarged spleen.

Finding the Cause

Your physician will review your medical history, perform a physical exam to look for leukemia symptoms, and order blood tests to measure levels of white blood cells and platelets. If the test results are abnormal, your doctor may recommend a bone marrow biopsy to help identify the type of leukemia you have and to guide treatment decisions. In some cases, a lumbar puncture may be necessary to determine if leukemia cells have spread to the cerebrospinal fluid, which nourishes the spinal cord and brain.

All people with chronic myeloid leukemia and about one-quarter of adults with acute lymphocytic leukemia have a genetic abnormality known as BCR-ABL, which leads to production of a protein that promotes cancer growth. As such, if testing reveals that you have one of these forms of leukemia, your doctor will probably order genetic testing to identify BCR-ABL. This testing is important because your physician can prescribe treatments that specifically target BCR-ABL and its related protein.

Originally published in 2016, this post is regularly updated.

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