What are Other Names for this Condition? (Also known as/Synonyms)

• MA (Myelophthisic Anemia)

What is Myelophthisic Anemia? (Definition/Background Information)

• Myelophthisic Anemia (MA) is a blood disorder caused by the destruction and replacement of normal hematopoietic cells. It may be caused by an underlying infectious disease, malignancy, or chronic inflammatory condition
• It is a type of normocytic anemia, which means that the size of red blood cells (RBCs) is within normal limits; however, peripheral blood exam shows immature RBCs. It is also a type of hypo-proliferative anemia since the bone marrow does not make adequate RBCs
• Anemia is defined as reduced hemoglobin levels, red blood cell count, and hematocrit below the optimal range. Broadly, anemia can be classified depending on the size of the RBCs as microcytic anemia, where the red blood cell size is decreased; macrocytic anemia (RBC size is increased); normocytic anemia (normal size of RBC is seen)
• Hematopoietic cells are essential in creating red blood cells and distributing oxygen throughout the body. Myelophthisic Anemia may also be considered a type of bone marrow failure. The condition can be diagnosed with a blood test and bone marrow examination
• Individuals with breast or lung cancer, osteoporosis, or fungal infections have a greater risk for the condition. Some signs and symptoms of Myelophthisic Anemia are abdominal pressure and hepatomegaly (swollen liver)
• Severe Myelophthisic Anemia can lead to excessive bleeding and hypertension. Blood transfusions may be used to treat the condition. Most cases of Myelophthisic Anemia are not preventable. The prognosis of Myelophthisic Anemia depends on the underlying cause

Who gets Myelophthisic Anemia? (Age and Sex Distribution)

• Myelophthisic Anemia can occur in individuals of any age group
• Both males and females are affected, and no gender preference is observed
• Myelophthisic Anemia occurs more frequently in countries where proper access to medical care is challenging

What are the Risk Factors for Myelophthisic Anemia? (Predisposing Factors)

The following can increase the risk for Myelophthisic Anemia:

• History of underlying malignancy or chronic inflammatory conditions
• Infectious diseases
• Breast, prostate, or lung carcinomas
• Advanced-stage melanoma

It is important to note that having a risk factor does not mean one will get the condition. A risk factor increases one's chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Myelophthisic Anemia? (Etiology)

Myelophthisic Anemia is a form of hypo-proliferative anemia caused by a decrease in red blood cells (RBCs) due to crowding out of the bone marrow cells by an infiltrative process. This condition has extensive fibrosis within the bone marrow (scarring). Bone marrow fibrosis is caused by various inflammatory chemicals such as TNF alpha and interleukins.

Other causes of hypo-proliferative anemia include:

• Nutritional deficiencies
• Toxin exposure
• Endocrine abnormalities such as hypothyroidism, hyperthyroidism, and renal osteodystrophy
• Malignancies of blood cells
• Bone marrow failure due to a variety of reasons

The infiltrative process may occur due to the following:

• Metastatic cancers, commonly breast, prostate, and blood cancer
• Infections causing granulomas within the bone marrow
• Granulomas caused by non-infectious disorders such as sarcoidosis, lipid storage disorders, primary myelofibrosis (bone marrow fibrosis that occurs from unknown causes), and autoimmune disorders

What are the Signs and Symptoms of Myelophthisic Anemia?

Myelophthisic Anemia can be symptomatic or asymptomatic; the severity of symptoms varies from individual to individual. The following are some of the signs and symptoms of Myelophthisic Anemia:

• Paleness of skin
• Dizziness and fatigue
• Shortness of breath
• Abdominal pain and pressure
• Exercise intolerance tachycardia (when the heart beats faster than usual)
• Splenomegaly (enlarged spleen)
• Hepatomegaly (enlarged liver)
• Early satiety - eating small quantities of food causes a feeling of fullness
• Cachexia causing unintentional weight loss
• Portal hypertension - increased blood pressure within the portal venous system

Additionally, signs and symptoms of the underlying causative condition may be noted.

How is Myelophthisic Anemia Diagnosed?

The diagnosis for Myelophthisic Anemia may include:

• Complete physical examination and evaluation of medical history
• Blood tests such as:
  • Complete blood count (CBC) test; CBC test will indicate pancytopenia
  • Red blood cell indices test
  • Reticulocyte count test
  • Peripheral blood smear exams: Reticulocyte count in the peripheral blood is decreased
  • Liver function test
• Imaging studies to assess the underlying health condition causing Myelophthisic Anemia, if necessary
• Bone marrow examination/biopsy: It will demonstrate the infiltrative process and the presence of fibrosis
• Differential diagnosis: It is important to rule out iron deficiency, vitamin B deficiency, folic acid deficiency, and anemia of chronic disease before establishing a diagnosis

Many clinical conditions may have similar signs and symptoms. Your Healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the Possible Complications of Myelophthisic Anemia?

The following are some of the possible complications of Myelophthisic Anemia:

• Refractory thrombocytopenia - abnormally low platelet levels that do not improve with treatment
• Infection due to leukopenia (decreased white blood cells in the body)
• Excessive bleeding due to pancytopenia (decreased levels of red blood cells, white blood cells, and platelets)
• Complications that may develop from the underlying condition/malignancy
• Severe anemia causing various complications

How is Myelophthisic Anemia Treated?

The following treatment measures may be used for Myelophthisic Anemia:

• Treatment of the underlying cause, which is critical for improved outcomes 
• Blood transfusions
• Erythropoietin therapy

Regular medical screening at periodic intervals with tests and physical examinations is necessary and highly recommended.

How can Myelophthisic Anemia be Prevented?

Most cases of Myelophthisic Anemia cannot be prevented. Prevention of the condition depends on adequate management of the underlying cause.

What is the Prognosis of Myelophthisic Anemia? (Outcomes/Resolutions)

The prognosis of Myelophthisic Anemia depends on the type and severity of the underlying cause.

• Individuals with infectious or inflammatory causes may have a better prognosis than those with an underlying malignancy
• In cases of advanced stages of carcinomas, such as when metastasis to the bone is observed, the prognosis is generally poor

Additional and Relevant Useful Information for Myelophthisic Anemia:

The functions of the three primary blood cells produced in the bone marrow include:

• RBCs or erythrocytes: They carry and deliver oxygen from the lungs to the tissues so that they can carry out cellular respiration
• WBCs or leukocytes: These cells fight against infection and also play a role in inflammation
• Platelets: These cells help in clot formation whenever there is a bleeding