Observations on the haemopoietic response to critical illness

Article Abstract:

Irregularities in blood cell production frequently accompany multiple organ failure. There is no definition of this syndrome that is generally accepted, but common features associated with sequential or progressive multiple organ failure and impaired hemopoiesis (blood cell synthesis) include an increased metabolic rate, infection, and failure of one or more major organs such as the lungs, kidneys, heart, or liver. To further investigate this syndrome, the characteristics of 24 intensive care patients were observed. The average age of the patients was 52 years old, and 64 percent (17 patients) died. Particular attention was paid to bone marrow hypoplasia (reduced blood cell production in the bone marrow). A total of 44 bone marrow samples were collected from these patients, and morphological examination and granulocyte-macrophage colony forming cell (GM-CFC) assays were performed. Observed abnormalities included: an overall reduction of blood cells, which was progressive; increased activity of phagocytic macrophages (white blood cells that engulf foreign bodies); and abnormal bone marrow structure with increased accumulation of hyaluronic acid glycosaminoglycan. Gelatinous degeneration of the bone marrow was also observed, and corresponded with the structural irregularities. Peripheral blood levels of red and white blood cells and platelets were measured. Anemia was found in almost all of the patients. It is concluded that this disturbed hemopoietic environment, along with hyaluronic acid proteoglycan accumulation, may significantly contribute to impaired hemopoietic response and subsequent blood disorders in critically ill patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

Testing, Bone marrow, Critically ill

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Intrathoracic extramedullary hematopoiesis in beta-thalassemia intermedia

Article Abstract:

Thalassemia is an inherited form of anemia that is caused by the production of abnormal hemoglobin (the substance that carries oxygen in red blood cells). It is most common in people of Mediterranean ancestry, especially Greeks and Italians. Thalassemia major (Cooley's anemia) is the most severe form of the disease, which can be fatal. Thalassemia minor is a mild form of the disease that often does not cause any symptoms. Extramedullary hematopoiesis (the formation of red blood cells outside of the bone marrow) can occur in patients with thalassemia, because the anemia provides a constant stimulus for the formation of new red blood cells. Extramedullary hematopoiesis is most common in the liver, spleen, and lymph nodes. It is rare in the thoracic region (intrathoracic extramedullary hematopoiesis), but it can occur when bone marrow is extruded from the ribs or vertebra. The solid mass that is created as a result of intrathoracic extramedullary hematopoiesis can be seen on X-ray. Computed tomography and magnetic resonance imaging should be performed to confirm the diagnosis. In most cases, surgery is not recommended. Radiation therapy can be used to reduce the size of the mass. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Thalassemia

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Haemopoietic stem and progenitor cells in the treatment of severe autoimmune diseases

Article Abstract:

Removal and transplantation with a patient's own hemopoietic stem cells (HSCs) may prove beneficial in patients with connective tissue and autoimmune diseases. HSCs are cells in the blood system capable of further developing into the various specialized types of blood cells as well as reproducing themselves. Researchers specializing in connective tissue diseases and bone marrow and blood transplants have proposed studying the preliminary effects of HSC treatment in patients with advanced connective tissue disease. Treatment would involve removing, isolating, and possibly reproducing or treating HSCs from the patients' blood, followed by full-body irradiation. Doctors would then inject these HSCs back into the patient. The treatment may not be successful if the source of the disease is in the stem cell. The risk of death associated with this treatment is 3%-5%.

Care and treatment, Usage, Autoimmune diseases, Hematopoietic stem cells, Connective tissue diseases

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