Bone Marrow Depression

If you are about to receive chemotherapy as part of your treatment for cancer you will become familiar with the term, bone marrow depression. This leaflet will explain what it means, why a full blood count is taken before giving each dose of chemotherapy and sometimes in between, also how chemotherapy affects your bone marrow. It also contains advice for when you are at home.

What does my blood do?

Blood is made up of 3 different types of cell:

• Millions of new blood cells are produced in the bone marrow each day and when mature they are released into your blood stream to carry out their functions.

• Red cells carry oxygen.

• White cells fight infection.

• Platelets help control bleeding.

How does Chemotherapy affect my Blood?

All chemotherapy affects the bone marrow; reducing the amount of red cells, white cells and platelets released into your circulation. This is called 'bone marrow depression' and, may occur 10 to 14 days following chemotherapy. Usually your bone marrow has fully recovered before the next treatment of chemotherapy. You will be required to have a blood test prior to administration of each cycle of chemotherapy and sometimes 10 days afterwards. If your red cell, white cell or platelet count is low, your treatment may be delayed to give them time to recover; or the dose of drugs you receive may be reduced.

Bear in mind, everyone reacts differently to chemotherapy, and most people complete treatment successfully without major complications.

The clinical term for a low red cell count is anaemia. The red cells carry oxygen around your body so when these are low you may experience:

• Dizziness, Pallor

• Fatigue

• Shortness of breath

• Tiredness

Can I do anything?

You can help relieve some of the symptoms of anaemia by following some simple measures.

• Get adequate rest

• Avoid strenuous exertion

• Try to eat a well balanced diet.

Sometimes it is necessary to have a blood transfusion if your red blood cell count remains low. The clinical term for low white cells is neutropenia. You may hear this word being mentioned. White blood cells help fight infection, so when your count is low you become more prone to infection as your resistance is reduced. Some signs of infection are:

• High temperature (38°C or 100.4°F or above)

• Fever

• Shivering, shaking

• Sore throat • Sore mouth ulcers

• Ear ache

Can I do anything?

To reduce the possibility of infection, it is important to:

• Maintain good personal hygiene (daily bath/shower)

• Keep your mouth clean

• Avoid exposure to adults/children with infections (colds, flu etc)

• Avoid crowded places

• Inspect your skin daily for signs of swelling or redness.

• Seek medical advice immediately if you develop signs of infection.

While your white cell count is low your resistance to infection is reduced. The main treatment for this is to prevent infection. Sometimes you may have to go into hospital to have intravenous antibiotics if your ability to fight infection is seriously impaired.