BONE MARROW

ABNORMALITIES

SURESH KUMAR P
L-2018-V-39-M
Bone Marrow
Spongy tissue inside some of bones.
• It contains stem cells
The stem cells can develop into
• RBC -Carry oxygen through body,
• WBC -Fight infections,
• PLATELETS -Blood clotting.
Hematopoitic hierarchy Of Bone marrow
Bone marrow diseases/Abnormalities
• Problems with the stem cells or how they develop:
• In leukemia, a cancer of the blood, the bone marrow makes abnormal
white blood cells
• In aplastic anemia, the bone marrow doesn't make red blood cells.
• In myeloproliferative disorders, the bone marrow makes too many
white blood cells.
• Other diseases, such as lymphoma, can spread into the bone marrow
and affect the production of blood cells.
Causes of bone marrow
diseases/Abnormalities
Genetics

Environmental factors.
Bone marrow abnormalities:
Gross microscopic characteristic of bone marrow in different
abnormalities
Colour - Unusual red in anaemia.
Colour - Grey in leukemic conditions.
Gelatinous appearance - seen in starved animals, animals with
chronic wasting diseases (TB, JD).
Generalised increase in hemopoitic cells
• Hypercellular when one or more cell lines exhibit
increased proliferation in response to peripheral needs
or demands
• Immune-mediated hemolytic anemia (IMHA)
• Immune-mediated thrombocytopenia (IMT)
• Blood loss iron deficiency anemia with an associated
thrombocytosis
• Feline leukemia virus (FeLV)-associated anemia.
Generalised decreases in hematopoitic cells
Hypocellular / Aplastic bone marrow
Drug-induced causes of aplastic anemia
• Estrogen toxicity in dogs
• Phenylbutazone toxicity in dogs,horse
• Trimethoprim-sulfadiazine administration in dogs
• Bracken fern poisoning in cattle and sheep
• Trichloroethylene-extracted soybean meal in cattle
• Griseofulvin toxicity in cats
• Various cancer chemotherapeutic agents and radiation.
Parvo viral infection
Feline leukemia virus
Ehrlichia canis infection
Acute Bone Marrow Injury And Necrosis
• Necrosis caused by ischemia from damage of the microcirculation or by
direct damage to the hematopoietic cells.
• Septicemia and/or endotoxemia
• Feline infectious peritonitis,Parvovirus, Ehrlichia canis infection in dogs
• Drug administration
Chemotherapeutic agents,
Estradiol [dogs],
Phenobarbital,
Mitotane,
Carprofen,
Metronidazole, Colchicine,Fenbendazole, and Cephalosporin antibiotics.
Gelatinous Transformation of Bone Marrow
• Morphologic changes in bone marrow
• Loss of hematopoietic cells and the atrophy of fat with
the deposition of gelatinous substances in the marrow
spaces.
Myeloid & Erythroid Cell Ratio Of Bone
Marrow (ME Ratio)
• In microscopic examination ME ratio is main criteria for diagnosing
different bone marrow abnormalities.
• ME ratio increases in following conditions:
1. Infections
2. Leukaemia
3. Leukemoid reaction
4. Hypoplasia of erythroid cells
• ME ratio decreases in
1. Depression of leucocytosis
2. Hyperplasia of erythroid series.
The alterations in ME ratio of bone marrow in
diferent Abnormalities/Diseases:

1. Leukemia: The immature leucocytos, lymphocytes.

monocytes and granulocytes increase in number.
The erythroid series cells decrease and ME ratio increases.
2. Canine malignant lymphoma: Hyperplasia of myeloid cells
along with hypoplasia of erythroid cells and the ME ratio
increases.
3. Bovine lymphoma: Lymphocyte increase over 30% due to
bovine lymphoma with an increase in ME ratio.
Pathogenesis of leukemic syndrome
4.Granulocytic leukemia: It is rare in bovines.
In this the bone marrow activity suppresses and more than 70% cells are of blast
type(immature).
On differential leucocytic count, large number of immature form of granulocytes
are present in peripheral blood.
In dogs, hyperplasia of bone marrow occurs due to granulocytic leukemia.
The most characteristic cells are myeloblast, promyeloblast, myelocyte and
metamyelocyte.
In marrow the erythrocyte element decreases in percent.

5.Myelomatosis: Myelomatosis is common in cat and horses In this condition the

number of plasma cells increases.
6.Monocytic leukemia: It mostly occurs in cats and dogs. Immature
monocytes increase in number in this condition.
7.Agranulocytosis: In this condition, there are mostly stem cells present
in marrow due to maturation arrest. this condition may also occur due
to depression of bone marrow due to certain medicines.
8.Infectious mononucleosis: In this disease condition, myeloid
hyperplasia occurs and there is increase in number of immature cells in
blood.
9.Pernicious anemia: In this condition, an increase in number of
megaloblasts has been observed.
10.Anemia: In hemorrhagic, hemolytic and sickle cell anemia, the
erythroblasts and normoblasts are increased in number.
11.Aplastic anemia:
All the cell types are reduced in number.
Differential Ieucocytic count is unaltered.
If erythroid activity increases, it is a good sign of recovery.
12.Active polycythemia: In this disease, hyperplasia of erythroid
elements occur along with hyperplasia of granulocytes and
megakaryocytes.
13.Primary thrombocytopenic perpura:
There is increase in number of megakaryocytes.
14.Chronic pneumonia: ME ratio increases along with increase in
myeloid and lymphoid elements and decrease in erythroid
series.
15.Uremia: Granulocytes and lymphocytes increase in number
alongwith decrease in erythroid series cells.

16.Traumatic pericarditis: Increase in lymphocytes is seen along

with decrease in myeloid and erythroid series cells.

17.Pyelonephritis: There is an increase in lymphocytes and

myeloblasts while erythroid cells are decrease in number.
18.Liver abscesses: Erythrocytic series is depressed while
lymphocytes increase along with slight increase in
immature neutrophils.
19.Pyometra: In pyometra megakaryocytes increase in
number along with a disturbed maturation of neutrophilic
cells.
20.Canine distemper: The immature myeloid tissue
increase in number in bone marrow.
21.Filariasis: Hyperplasia of erythroid cells along with
decreased ME ratio of bone marrow cells.
22.Chronic kidney diseases: lymphocytes, monocytes and ME
ratio increase with increase in band cells and immature
neutrophils. There is decrease in erythroid elements.

23.Osteomyelitis: This is inflammatory condition of bone.

Infection gets access to marrow through local wound fracture
etc or by hematogenous route.it invoves local bones and
usually pyogenic infections cause purulent exudation.in this
condition there is increase in number of neutrophilic cells.

24.Fibrosis: It occurs as a sequel to hypoplasis or aplasia. It

may occur with myxomatous degeneration due to starvation.
25.Panmyelosis: It is the cancerous growth of
erythrocytic or granulocytic or mega karyocytic series.
The tumor cells replace the bone marrow and also
appears in blood.
These cells can also be demonstrated in liver spleen
and lymphnodes.
26.Myelofibrosis: In this myeloid leukemia occurs which
is followed by fibrosis of bone marrow.
Causes:Secondry to malignancies,Immune mediated
haemolytic anemia,Irradiation,Congenital
anemias(Pyruvate kinase deficiency)
Treatment: Immuno suppressive therapy.
Diagnosis (blood and bone marrow tests)

• Blood count tests

• Bone marrow biopsy and aspiration
• Bone marrow test
• Reticulocyte count test
• Identification of leukaemic cells in peripheral blood is the first
preliminary step in the diagnosis of ALL (Acute lymphoblastic
leukemia)
Treatment
• Depend on the disorder and how severe it is.
• Involve medicines, blood transfusions or a bone marrow transplant.
• Medicines
• Injectable cytotoxic chemotherapy, in canine Acute Leukemia yields a reasonable
overall response rate (64%)
• Corticosteroids
• Anthracycline
• Vincristine
• L-asparaginase
• No apparent cures, due to the rapid onset of chemoresistance during treatment.
• Dose-intense chemotherapy protocols, supportive care, and potentially, the
concurrent use of more targeted therapeutic agents.
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