Myelophthisic Anemia

Excerpt

Anemia is reduced hemoglobin, red blood cells, or hematocrit levels below their lower normal range. There are different types and causes of anemia. Anemia is subdivided into microcytic, macrocytic, and normocytic variants. Myelophthisic anemia is categorized under the normocytic variety of anemia. Normocytic anemia has the mean corpuscular volume (MCV) within the normal range of 80 to 100 fL. Other types of normocytic anemia apart from myelophthisic anemia include aplastic anemia, anemia of chronic disease, and anemia of renal disease. Microcytic anemia is MCV below 80 fL, including sideroblastic anemia, iron deficiency anemia, and thalassemia. The macrocytic anemias have MCV greater than 100 fL, including megaloblastic and non-megaloblastic anemia. Anemia can be asymptomatic or can present with mild to severe symptoms. Severe symptoms can be devastating since they can limit the functional capacity of the individual to carry out even basic activities of daily living. A recent article by Kassebaum NJ et al reported that about 27% of the world population is affected by anemia, with iron deficiency anemia being the most common subtype implicated. Anemia considerably affects morbidity and mortality; thereby, it is of the utmost relevance in making timely diagnoses and undertaking effective treatment.

Myelophthisic anemia is characterized by immature erythrocytes in the peripheral blood due to abnormal tissue infiltration (crowding out) of the bone marrow. It is a hypo-proliferative variant of anemia because it results from inadequate production of red blood cells from the bone marrow. Hypoproliferative anemia differs from other forms since the reticulocyte count is usually low compared to anemia caused by increased blood loss or peripheral destruction, wherein the reticulocyte count mostly increases. Other causes of hypo-proliferative anemia include nutritional deficiencies, toxin exposures, endocrine abnormalities, hematologic malignancies, and bone marrow failure syndromes. This topic focuses on myelophthisic anemia and its epidemiology, etiology, pathophysiology, complications, evaluations, and management.