Marrow disorders

Anemia of chronic disease Anemia of the elderly Malignant bone marrow disorders Peripheral... 

Erythropoietin stimulates erythroid proliferation and differentiation by interacting with specific erythropoietin receptors on red cell progenitors. It also induces release of reticulocytes from the bone marrow. Endogenous erythropoietin is produced by the kidney in response to tissue hypoxia. When anemia occurs, more erythropoietin is produced by the kidney, signaling the bone marrow to produce more red blood cells. This results in correction of the anemia provided that bone marrow response is not impaired by red cell nutritional deficiency (especially iron deficiency), primary bone marrow disorders (see below), or bone marrow suppression from drugs or chronic diseases. 

In selected patients, erythropoietin may also be useful for the treatment of anemia due to primary bone marrow disorders and secondary anemias. This includes patients with aplastic anemia and other bone marrow failure states, myeloproliferative and myelodysplastic disorders, multiple myeloma and perhaps other chronic bone marrow malignancies, and the anemias associated with chronic inflammation, AIDS, and cancer. Patients with these disorders who have disproportionately low serum erythropoietin levels for their degree of anemia are most likely to respond to treatment with this growth factor. Patients with endogenous erythropoietin levels of less than 100 IU/L have the best chance of response, though patients with erythropoietin levels between 100 and 500 IU/L respond occasionally. These patients generally require higher erythropoietin doses (150-300 IU/kg three times a week) to achieve a response, and responses are often incomplete. 

Malignant bone marrow disorders Endocrine abnormalities... 

Because serious and fetal blood dyscrasias can occur after the administration of chloramphenicol, it should be used only in serious infections for which less potentially dangerous drugs are ineffective or contraindicated. Chloramphenicol is contraindicated in patients with known hypersensitivity or intolerance to this drug, who have blood cell or bone marrow disorders, or who are undergoing dialysis and have other complications such as cirrhosis. 

Indications Chronic myelogenous leukemia, bone marrow disorders... 

Knutsen BB (1978) Chemically induced agranulocytosis. 2 cases of bone marrow disorder after exposure to paint, sealing-wax and glue. Tidsskr Nor Laegeforen 98 888-890... 

Marrow disorders 40% of hypoplasia 10% of extensive bony metastases 50% of myelosclerosis... 

Kudla (USA) 1997 Analysis of historical exposures to two workers with bone marrow disorders in the printing trade Benzene, toluene Detailed worker interviews and workplace descriptions Qualitative estimates generated... 

Kudla, I. (1997). Exposure to benzene-contaminated toluene and bone marrow disorders—A retrospective exposure assessment Appl Occup Environ Hyg 12, 11-14. 

HUMAN HEALTH RISKS EPA Group B2 probable human carcinogen Acute Risks allergic skin reaction tissue destruction in mucous membranes, upper respiratory tract, eyes and skin Chronic Risks alters genetic material bone marrow disorders damage to peripheral and central nervous systems. 

Erythropoietin is routinely used for the anemias associated with renal failure and is sometimes effective for patients with other forms of anemia, eg, primary bone marrow disorders or anemias secondary to cancer chemotherapy or zidovudine treatment, bone marrow transplantation, AIDS, or cancer. Erythropoietin s toxicity is minimal and usually results from excessive increase in hematocrit. 

Hypoplastic i.e., aplastic anemia Aplastic Anemia caused by deficient red cell production due to bone-marrow disorders. 

It was shown that camptothecin inhibits DNA and RNA synthesis at a concentration of Smmol/l by using HeLa and LI 210 cell lines. It shows inhibitory activity against a number of tumor cell lines and possesses a wide spectrum of antitumor activity [5]. Clinically it has side effects, such as disorder of the bone marrow, disorder of the digestive system such as nausea, vomiting, and diarrhea, and a decrease in white blood cells. Consequently it... 

PMHx cardiovascular, diabetes, seizures, blood/bone marrow disorders, constipation/bowel obstruction... 

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