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Bone Marrow Failure in Children

Medically reviewed by Last updated on Mar 2, 2022.

What is bone marrow failure?

Bone marrow failure is a condition that prevents your child's bone marrow from producing enough healthy blood cells.

What causes bone marrow failure?

Your child may have been born with the condition, or it may have been caused by any of the following:

  • Exposure to chemicals, such as benzene
  • Radiation or chemotherapy
  • Bacterial or viral infections
  • Certain medicines, such as pain medicine or antibiotics
  • Immune system problems

What are the signs and symptoms of bone marrow failure?

Bleeding is the most common symptom. Your child's nose, gums, or skin may bleed or bruise easily. You may see blood in his urine or bowel movements. He may also have any of the following:

  • Fever, fatigue, or shortness of breath
  • Colds or infections that do not get better or keep coming back
  • Mouth and tongue sores, tooth decay, or tooth loss
  • Nail loss or deformed nails
  • Delayed growth, a small head, or shorter height than normal for his age
  • Digestive problems, or greasy, foul-smelling bowel movements
  • Premature (early) graying of hair or more hair loss than usual
  • Pale skin or skin with brown or red pinpoint spots

How is bone marrow failure diagnosed?

Your child's caregiver may ask you questions about your child's past illnesses and current medicines. He may ask if you have any family members with bone marrow disorders or cancer. Your child may need any of the following:

  • Blood tests: Your child's blood is taken for a blood count or to look for infection.
  • Bone marrow biopsy: A small sample of your child's bone marrow is taken from a bone and sent to a lab for tests.

  • Genetic tests: These tests show if a hereditary disease is causing your child's symptoms.

How is bone marrow failure treated?

  • Growth factors: These medicines help your child's bone marrow produce more blood cells.
  • Immunosuppressive medicine: These help prevent the body from attacking its own bone marrow. This may allow your child's bone marrow to make more blood cells.
  • Blood transfusion: Your child may need to receive blood through an IV. He may get only part of the blood, such as red blood cells, platelets, or plasma.
  • Bone marrow transplant: Your child is given healthy bone marrow from a donor whose bone marrow closely matches your child's.
  • Peripheral blood stem cell transplant: Your child will receive stem cells. Stem cells are able to become other cells, such as red blood cells. Stem cells can also travel to bone marrow and start growing into new cells.

Treatment options

The following list of medications are in some way related to or used in the treatment of this condition.

What are the risks of bone marrow failure?

  • Treatment of bone marrow failure may make it necessary for your child to stay in the hospital for a time. Medicines may damage your child's organs or bones, or cause growth problems. A bone marrow transplant and medicines may increase your child's risk of cancer, such as liver cancer or leukemia. He may have bleeding, infections, or a life-threatening allergic reaction.
  • If left untreated, your child's condition may worsen. He may be weak and get tired easily. He may have delayed physical and mental growth. He may have severe bleeding. If the bleeding is not treated, your child may develop life-threatening hypotension (low blood pressure). Your child may develop aplastic anemia, which is a life-threatening anemia. He may also be prone to a disease called myelodysplastic syndrome, which can progress to leukemia.

How can I help my child?

  • Do not give medicines that can cause bleeding: Ask your child's caregiver before you give any medicines or herbal supplements to your child. Do not give him aspirin, ibuprofen, or antihistamines.
  • Wash hands often: You, your child, and everyone in your home must wash hands throughout the day. Use soap and water. Use germ-killing gel if soap and water are not available. Wash after bathroom use and diaper changes. Wash before food is prepared and eaten. Tell your child not to touch his eyes, nose, or mouth unless he has washed his hands first.
  • Protect your child: Do not let your child play contact sports. Have him play quietly. Contact sports and rough play can cause bruising or serious bleeding. Give your child a soft toothbrush, and teach him to brush his teeth slowly and gently. This may help prevent bleeding gums. Have your child use lip balm to prevent his lips from drying and cracking. Apply lotion to his skin to prevent scratching and skin tears. Encourage your child to wear sunscreen when he is in the sun.
  • Keep your child away from those who are sick: This decreases your child's chance of getting sick or getting an infection. Ask a caregiver if your child should get vaccines to keep him from getting the flu and other illnesses.
  • Prevent constipation: 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.

Where can I find support and more information?

  • Aplastic Anemia & MDS International Foundation
    100 Park Ave., Ste 108
    Rockville , MD 20850
    Phone: 1- 800 - 747-2820
    Web Address:
  • Fanconi Anemia Research Fund, Inc.
    1801 Willamette St., Suite 200
    Eugene , OR 97401
    Phone: 1- 541 - 6874658
    Phone: 1- 800 - 8284891
    Web Address:

When should I contact my child's caregiver?

Contact your child's caregiver if:

  • 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 or a cough, or he feels weak and achy.
  • You have questions or concerns about your child's condition or care.

When should I seek immediate care?

Seek care immediately or call 911 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.
  • Your child's urine has blood in it, is red, or smells foul.
  • Your child has a sudden, severe headache, feels dizzy, or is more tired than usual.
  • Your child has difficulty breathing.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child. 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.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.