Side effects of systemic cancer therapy - bone marrow suppression
Lineages and timing
- Suppression of the rapidly dividing haematopoietic compartment - the dose-limiting toxicity of most cytotoxic chemotherapy
- Three lineages, three different problems and three different timelines
| Lineage | Consequence | Nadir | Recovery |
|---|---|---|---|
| Neutrophils | Infection - the one that kills | Days 7-14 | Days 21-28 |
| Platelets | Bleeding | Days 7-14 | Days 21-28 |
| Red cells | Fatigue, dyspnoea | Later (120-day RBC lifespan) | Slow, cumulative |
- *Neutropenic fever is the emergency; anaemia and thrombocytopenia rarely are*
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