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Myelophthisic Anemia
Introduction:
- It is anemia occurring due to infiltration of bone marrow with abnormal cells or tissue components
Etiology:
- Hematological malignancy – Leukemia, lymphoma, myeloma etc.
- Metastatic deposits – Ex – Carcinomas of breast, prostate, stomach etc.
- Miliary tuberculosis, fungal infections
- Lipid storage disease – Ex – Goucher’s disease
- Osteopetrosis
- Myelofibrosis
- Other non-cellular material- Oxalosis
- Marrow necrosis- Sickle cell anemia, septicemia, arsenic therapy in APML
Investigations:
- Peripheral smear
- Normocytic, normochromic anemia
- Tear drop cells
- Leucoerythroblastic reaction – many normoblasts are seen along with immature myeloid precursors. Absence of this does not rule myelophthisic anemia.
- Carcinocythemia- Clumps of metastatic cells in peripheral smear
- Bone Marrow
- Aspiration is often a dry tap
- Bilateral bone marrow biopsy may be needed
- Finding depend on cause
- CT Neck, chest, abdomen, pelvis/ Whole body PET-CT- To identify the source of metastasis
- 99m Tc scan- Identifies marrow infiltration by Goucher cells
Prognosis:
- Overall survival is short
Treatment:
- Treatment of cause
Figures:
Figure 8.11.1- Bone marrow biopsy showing metastatic carcinoma of breast
Figure 8.11.2- Bone marrow biopsy showing metastatic adenocarcinoma
Figure 8.11.3- Bone marrow biopsy showing granuloma
Figure 8.11.4- Crystals within bone marrow highlighted by polarizing microscope
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