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What are the Effects of Chemotherapy on Bone Marrow?

Amy Hunter
Amy Hunter

The effect of chemotherapy on bone marrow is called bone marrow suppression. This is a condition where the bone marrow is unable to make an adequate supply of blood cells. Chemotherapy targets fast growing cells, such as cancer, however, bone marrow cells that develop into red and white cells, as well as platelets, are affected too. Bone marrow suppression can affect any or all of the blood cells manufactured in bone marrow. The symptoms of bone marrow suppression vary, depending on the cells affected.

Anemia is a common condition caused by the effect of chemotherapy on bone marrow. Anemia is a condition where the body does not produce enough red blood cells. Symptoms of anemia include fatigue, pale skin, gums, and mucous membranes, a feeling of being out of breath, heart palpitations, rapid heart rate, and dizziness. Mild anemia may not require treatment, once chemotherapy is completed, the body will begin producing red blood cells normally. More severe cases require medications to encourage the body to produce red blood cells, iron supplements, and, in severe cases, blood transfusions.

Three pieces of bone with the marrow in the middle.
Three pieces of bone with the marrow in the middle.

Neutropenia, a potentially serious effect of chemotherapy on bone marrow, occurs when the body cannot manufacture white blood cells rapidly enough. White blood cells fight infection in the body, so low levels increase the body's susceptibility to infection. Symptoms of neutropenia include chills, shortness of breath, cough, a fever greater than 100.5° Fahrenheit (38 Celsius°), and redness around an injury or opening in the body, such as an IV line. Avoiding crowds can minimize the chance of infection for individuals with low white blood cell counts. Prescription medications can boost the production of white blood cells and minimize the chance of infections. In severe cases, it may be necessary to delay chemotherapy.

A diagram of the anatomy of a bone, showing the bone marrow.
A diagram of the anatomy of a bone, showing the bone marrow.

When chemotherapy suppresses the production of platelets, it causes thombocytopenia. Platelets are responsible for clotting, so this effect of chemotherapy on bone marrow can result in free bleeding. Symptoms include easy bruising, heavy menstrual periods, petechiae, or red spots on the skin, and muscle and joint pain. Platelet transfusions and medication to stimulate platelet production are used to treat thombocytopenia.

After chemotherapy,  doctors may prescribe a patient blood transfusions to increase red blood cell levels.
After chemotherapy, doctors may prescribe a patient blood transfusions to increase red blood cell levels.

The effects of chemotherapy on bone marrow are some of the most grueling and serious side effects of chemotherapy. Help minimize the risks by washing hands thoroughly and often, avoiding medications that encourage bleeding, such as aspirin, contacting a physician at the first sign of infection, and getting adequate rest. Coping with bone marrow suppression allows continued treatment with chemotherapy, which is life-saving therapy for many illnesses.

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    • Three pieces of bone with the marrow in the middle.
      By: Maurice Metzger
      Three pieces of bone with the marrow in the middle.
    • A diagram of the anatomy of a bone, showing the bone marrow.
      By: Alila
      A diagram of the anatomy of a bone, showing the bone marrow.
    • After chemotherapy,  doctors may prescribe a patient blood transfusions to increase red blood cell levels.
      By: Pavle
      After chemotherapy, doctors may prescribe a patient blood transfusions to increase red blood cell levels.
    • Chemotherapy is typically administered in the hospital or at an infusion center, where trained professionals can watch for adverse reactions.
      By: Monkey Business
      Chemotherapy is typically administered in the hospital or at an infusion center, where trained professionals can watch for adverse reactions.
    • Because each patient reacts differently to chemotherapy, it's impossible to predict at the beginning how effective the treatment will be, as well as which symptoms it will cause.
      By: cleomiu
      Because each patient reacts differently to chemotherapy, it's impossible to predict at the beginning how effective the treatment will be, as well as which symptoms it will cause.