Childhood bone marrow disorders can either be inherited or occur randomly. These disorders can be treated, but require thorough medical testing.
Bone Marrow Should Be a Child's Defense Against Danger
All blood cells come from stem cells in bone marrow.
Children, like adults, need infection protection. Healthy bone marrow, the spongy substance inside our bones, produces three critical cells:
• Infection-fighting white blood cells
• Oxygen-carrying red blood cells
• Platelets, which stop bleeding by causing blood to clot.
When a child's marrow doesn't create enough of these, the failure can lead to diseases.
Bone Marrow Disorders Can Be Inherited
In some cases, bone marrow disorders are passed down in families. Hereditary bone marrow abnormalities include:
• Fanconi anemia, a rare disease in which blood stem cells in bone marrow collect damaged DNA
• Shwachman-Diamond syndrome (SDS), a condition that usually affects the bone marrow, pancreas and skeleton.
Bone Marrow Disorders Can also be Acquired
Some childhood bone marrow failures are caused by unknown factors and may occur randomly. Acquired bone marrow disorders include:
• Aplastic anemia, in which lower numbers of red blood cells cause levels of hemoglobin, a blood system oxygen-carrier, to drop. White cell counts also drop, leaving the patient open to infections, and fewer blood platelets cause blood clotting problems.
• Myelodysplastic syndrome, a condition that kills many of a child's produced blood cells and destroys them before they can leave the marrow.
Diagnosing Bone Marrow Disorders
Medical teams at Seattle Children's Hospital follow these steps to diagnose children's bone marrow disorders:
• Take a detailed health history
• Examine children for signs of illness
• Do blood tests to check the level of each kind of blood cell and study the cells under a microscope
• Remove a sample of bone marrow (called bone marrow aspiration or biopsy) and test the marrow sample
When Is It Time for a Transplant?
The National Marrow Donation Program says bone marrow or umbilical cord blood transplants may offer the best option for curing a child's bone marrow disorder. In general, patients respond best to transplants when:
• Their disease process is in its early stages
• When the disease is in remission or there is very little disease in the body
• When the disease is sensitive to chemotherapy
• When the children are in good overall health and their organs work well
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