Bone Marrow Failure In Children

WHAT YOU SHOULD KNOW:

• Bone marrow failure happens when your child's bone marrow does not produce blood cells. Bone marrow is the spongy red tissue inside your child's bones. It makes red blood cells (RBC), white blood cells (WBC) and platelets. Red blood cells carry oxygen to all the organs and tissues of your child's body. White blood cells help your child's body fight infection by attacking and killing germs. Platelets stop the bleeding when your child is cut or injured. Bone marrow failure may be inherited (something your child is born with). It may also be acquired (something that happens after birth). The aquired type may be caused by chemicals, infections, medicines, radiation, or problems with the immune system. Both types of bone marrow failure may lead to anemia (low RBC count).
  
  
• The signs and symptoms of bone marrow failure vary, but bleeding is the most common symptom. Your child may bruise or bleed easily, have nosebleeds, or have blood in his urine or bowel movements. He may have birth defects, such as heart, kidney, bone, or skin problems. He may have growth problems and may appear short, have a small head, or have deformed nails. He may often have infections, fevers, shortness of breath and tiredness. He may have pale skin, or skin that has coffee-colored spots. Blood tests, genetic tests, and a bone marrow biopsy are used to diagnose bone marrow failure. Blood transfusions, doner bone marrow transplants, doner blood stem cell transplants, and medicines, such as hematopoietic growth factors and immunosuppressants may be given. Diagnosing and treating bone marrow failure as soon as possible may decrease or relieve your child's symptoms, and prevent more medical problems.

INSTRUCTIONS:

Medicines:

• Keep a current list of your child's medicines: Include the amounts, and when, how, and why they are taken. Bring the list and the medicines in their containers to follow-up visits. Carry your child's medicine list with you in case of an emergency. Throw away old medicine lists. Give vitamins, herbs, or food supplements only as directed.
  
  
• Give your child's medicine as directed: Call your child's primary healthcare provider if you think the medicine is not working as expected. Tell him if your child is allergic to any medicine. Ask before you change or stop giving your child his medicines.
  
  
• Antibiotics: This medicine is given to help prevent or treat an infection caused by bacteria.
  
  
• Antifungal medicine: This medicine helps kill fungus that can cause illness.
  
  
• Antiviral medicine: This medicine may be given to fight an infection caused by a germ called a virus. Antiviral medicine may help to decrease the number of days your child is sick.
  
  
• Hematopoietic growth factors: These medicines are used to help your child's bone marrow produce more blood cells. They may include androgens, erythropoietin, G-CSF, and GM-CSF.
  
  
• Immunosuppressives: Immunosuppressive medicines help prevent the body from attacking its own bone marrow. This may allow the bone marrow to make more blood cells.
  
  
• Steroids: Steroid medicine may be given to help prevent the body from attacking its own bone marrow. This may allow the bone marrow to make more blood cells.

Ask for more information about where and when to take your child for follow-up visits:

For continuing care, treatments, or home services for your child, ask for information.

Keep your child away from people who have colds and the flu.

Also try to keep your child away from large groups of people while he is recovering from surgery. This decreases your child's chance of getting sick or getting an infection.

Wash your hands and your child's hands often.

This will help prevent the spread of germs. Encourage everyone in your house to wash their hands with soap and water after going to the bathroom. Also wash hands after changing diapers and before preparing or eating food.

Other ways to help your child:

• Certain medicines may cause problems for your child if he is exposed to sun without proper protection. Protect your child's skin from the sun by applying sunscreen to your child that has an SPF (sun protectant factor) of 30 or higher. Ask your child's caregiver for other ways to protect your child's skin from the sun.
  
  
• Do not allow your child to join in rough play or contact sports. These activities may cause bruising or a head injury, and lead to serious bleeding problems. Allow your child to rest and sleep as much as he needs.
  
  
• Give your child a soft-bristled toothbrush, and teach him to brush his teeth slowly and gently. Doing this may help prevent bleeding gums. Have your child use lip balm to prevent his lips from drying and cracking, and apply lotion to his skin to prevent scratching and skin tears.
  
  
• If your child is having hard, dry stools that are difficult to pass, he may be constipated. Constipation can cause bleeding in your child's bowel movement. Give your child fresh fruit and plenty of water to drink to avoid constipation. Ask your child's caregiver for more information about preventing and treating constipation.

CONTACT A CAREGIVER IF:

• Your child has a fever.
  
  
• Your child has cold skin and appears weak.
  
  
• Your child has a new rash.
  
  
• Your child has signs and symptoms of an infection, such as chills, a cough, or feels weak and achy:
  
  
• You have questions or concerns about your child's condition, medicine, or care.

SEEK CARE IMMEDIATELY IF:

• Your child has a fever.
  
  
• Your child has bleeding from his gums, mouth, or nose that cannot be stopped.
  
  
• Your child's bowel movement has blood in it or is dark-colored.
  
  
• Your child's urine has blood in it, is red, or is foul (bad) smelling.
  
  
• Your child has a sudden, severe headache, feels dizzy, or is more tired than usual.
  
  
• Your child has breathing problems.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Bone Marrow Failure In Children (Aftercare Instructions)