Bone Marrow

Hi

Is it possible to suck ( i don't know the medical term ) the excess bone marrow in case of over production so that we can avoid bone deformation?  Same concept of letting blood to decrease iron overload?


Manal

Hi Manal,

As far as I know the only way to prevent bone problems is adequate transfusion.  Bone deformation
occurs when hg is too low and bone marrow expands to in order to increase its efficiency in blood production.  Because the faulty genes in the marrow don't produce viable red blood cells the marrow continues to grow resulting in bone deformation and damage.  Therefore it is important to maintain a certain hg level and suppress the marrow and its efforts attempt the production of red blood cells or excess alpha (which is unnecessary beta is not present for it to combine and form alpha2 beta 2 = hemoglobin). 
I don't think you want to extract bone marrow, you want to suppress if with transfusion - if that answers your question. 

Adequate calcium is also important in healthy bones in thalassemia.  I am sure Andy would be the best person to further address this question.  Best of luck!

Bone marrow is removed under anesthetic using a long hollow needle from the donor for bone marrow transplants. The needle is usually inserted into the pelvic bone and does cause pain and the donor is sore for several days afterwards. That alone might keep it impractical to remove bone marrow, but the bone marrow is replaced by the body in 4-6 weeks, and with thal it would only increase the production of new marrow. As sharmin has stated, it is best to suppress overproduction of bone marrow by keeping the hemoglobin level up. In intermedia if anything that can be done to increase Hb production to a level that will minimize overproduction in the marrow, such as using hemoglobin enhancing drugs, or possibly natural substances such as wheatgrass or aloe, it is advised over transfusions.

I too am curious about this.  Does chemotherapy during transplantation kill all of this excess marrow, and if so, does that cause your heart to pump a lot harder or faster to compensate for not having all that excess marrow anymore?  Do you know if it's still possible to go through with a transplant if you have been maintaining a hemoglobin of 7.0 for over 20 years, and you have developed excess marrow complications?

Hi Dlevy,

Chemotherapy kills the old bone marrow with the Thal. genes so that they won't create any more faulty blood.

The heart has nothing to do with the marrow as it pumps blood and not marrow blood stays there the whole time except for the immune system (WBC etc) which might interfere with the graft of the new marrow react against it by recognising it as a foreign invasion; and that's the reason why patients undergoing the transplant are kept in antiseptic kinda environment so that infections can be avoided since the immune system is retarded and infections can thrive.

Regarding the other part of the question. It is not advised for the older patients because of the large number of antibodies could have been developed or received by transfusions as a person ages which again interfere with the transplant.

Furthermore the extent of liver fibrosis also causes complications in older patients.

Take care, Peace!