Introduction to Bone Marrow Cancer

What is Bone Marrow  Cancer?

Bone marrow cancer, also known as myeloma or multiple myeloma, is a kind of cancer that begins in the plasma cells that reside within the bone marrow. Plasma cells are a type of white blood cell produced in the bone marrow that aids in the production of antibodies to combat infection. Plasma cells become aberrant and grow uncontrollably in multiple myeloma. As the number of plasma cells increases, healthy cells are pushed out, resulting in low levels of red blood cells, white blood cells, and platelets. Bone pain, fractures, weariness, recurrent infections, weight loss, and numbness or tingling are also common symptoms. High calcium levels might also lead to dizziness and kidney issues. Blood/urine testing and bone marrow biopsy are used by the top cancer doctor in Bangalore to detect multiple myeloma.

Functions of Bone Marrow

1. Hematopoiesis – The process by which stem cells in the bone marrow produce blood cells is called hematopoiesis. This involves the proliferation and differentiation of stem cells into red blood cells, white blood cells and platelets.

2. Red blood cells carry oxygen from the lungs to tissues in the body. White blood cells fight infection. Platelets help with blood clotting.

3. Bone marrow produces billions of new blood cells every day to maintain normal levels in the bloodstream. Any disruption in marrow function can lead to low blood counts.

4. Energy Storage – Yellow bone marrow serves as an energy reserve, storing fat that can be converted to energy when needed.

Bone Marrow Production Declines With Age

At birth, bone marrow is entirely red. With age, more marrow becomes yellow as fat content increases. By adulthood, about half of the bone marrow is red and involved in blood cell production. As you get older, the amount of hematopoietic marrow continues to decrease being replaced by inactive yellow marrow. This leads to reduced blood cell production.

So in summary, bone marrow plays a vital role in hematopoiesis and blood cell production. It also serves as an energy store. Changes in bone marrow activity and composition occur over a lifetime.

Bone Marrow Biopsy: Procedure and Purpose

It is a medical procedure that removes a small sample of bone marrow tissue, usually from the hip bone. It is done to examine bone marrow cells under a microscope for abnormalities and diagnose certain conditions.

Purpose of Bone Marrow Biopsy

To diagnose blood cancers like leukaemia, lymphoma, and multiple myeloma. It helps classify cancer types and stages. To diagnose other non-cancerous marrow conditions like anaemia, infection, and inflammation. Monitor response and remission after cancer treatment. Identify the cause of abnormal blood test results.

Procedure

• The biopsy is typically done under local anaesthesia. The patient lies on their side or stomach.

•  A specialized hollow biopsy needle is inserted through the skin into the hip bone to extract a marrow sample. 

• Several samples may be taken from different insertion points.

• The sample is examined by a pathologist to look for abnormalities in blood cell production and appearance.

After the Biopsy

• Most patients can go home soon after. The area may feel sore for a few days.

• Results usually come back within a few days up to a week.

• In some cases, a bone marrow aspiration may also be done to obtain a liquid marrow sample.

Common symptoms and signs that may indicate bone marrow cancer

• Bone pain – Persistent pain in the bones, especially the back, hips and skull. Pain may worsen with movement.

• Fractures – Bones become weak and brittle, leading to frequent fractures and breaks.

• Fatigue – Feeling constantly tired and weak due to anaemia from abnormal blood cell production.

• Bruising or bleeding – Increased bleeding or easy bruising from low platelet counts.

• Infections – Frequent infections due to reduced white blood cells.

• Weight loss – Unexplained weight loss not tied to changes in diet or exercise.

• Numbness or tingling – Pinched nerves can cause numbness or tingling in arms, legs or other areas. 

• Swelling – Bone lesions or amyloid proteins can cause swelling in the arms, legs, and tongue.

• Constipation – Due to high calcium levels from bone breakdown.

• Mental confusion – Changes in mental status or confusion from high calcium. 

• Kidney problems – Kidney damage or failure from excess proteins.

If someone experiences persistent, unexplained symptoms like these, it’s important to see a doctor for blood tests and examinations. Early diagnosis of bone marrow cancers like leukaemia, lymphoma or myeloma is key for effective treatment. Being aware of the signs is vital.

Bone Marrow Transplant as a Treatment

 

Bone Marrow Transplant is a procedure where a patient receives healthy bone marrow cells from a donor. It is used to replace damaged or diseased bone marrow, allowing the body to make new, healthy blood cells. Certain cancers like leukaemia, lymphoma, and myeloma can damage the marrow. Chemotherapy also impairs marrow function. A transplant allows for higher chemotherapy doses to kill cancer cells. The new marrow then reconstitutes the blood. Transplants can also treat some non-cancerous diseases involving the blood and marrow.

Sources of Bone Marrow

• Autologous – Patient’s bone marrow removed and stored before high-dose treatment.

• Allogeneic – Bone marrow donated from a genetically matched sibling or unrelated donor. 

• Umbilical cord blood – Stem cells collected from newborn umbilical cords are another source.

Transplant Procedure 

• The patient undergoes intensive chemotherapy and/or radiation to destroy diseased marrow.

• Donor bone marrow cells are then infused intravenously, where they migrate to the marrow space.

• Over weeks to months, the new cells multiply and begin producing normal blood cells.

Recovery and Risks

• It takes 6 months or more to fully recover cell counts. Patient isolation and transfusions help support recovery.

• Risks include graft failure, graft vs host disease, infections, bleeding problems and organ damage.

• Overall survival rates depend on many factors – patient’s age and health status, cancer type and stage, donor matching, etc.

So in summary, bone marrow transplant can provide a chance for cure in many cancers and blood disorders, but carries significant risks and challenges during recovery.

Conclusion

 

In conclusion, bone marrow cancer, also called myeloma or multiple myeloma, is a type of cancer originating in the plasma cells of bone marrow. It causes an overgrowth of abnormal plasma cells which crowd out healthy blood cell production leading to complications like anaemia, bone damage, kidney failure and immuno suppression.