WordNet

a concavity in a surface produced by pressing; "he left the impression of his fingers in the soft mud" (同)impression, imprint
a long-term economic state characterized by unemployment and low prices and low levels of trade and investment (同)slump, economic crisis
a mental state characterized by a pessimistic sense of inadequacy and a despondent lack of activity
angular distance below the horizon (especially of a celestial object)
pushing down; "depression of the space bar on the typewriter"
sad feelings of gloom and inadequacy
remove the bones from; "bone the turkey before roasting it" (同)debone
the porous calcified substance from which bones are made (同)osseous_tissue
consisting of or made up of bone; "a bony substance"; "the bony framework of the body"
a shade of white the color of bleached bones (同)ivory, pearl, off-white
rigid connective tissue that makes up the skeleton of vertebrates (同)os
any of various squash plants grown for their elongated fruit with smooth dark green skin and whitish flesh (同)marrow squash, vegetable_marrow
the fatty network of connective tissue that fills the cavities of bones (同)bone_marrow
very tender and very nutritious tissue from marrowbones (同)bone_marrow
large elongated squash with creamy to deep green skins (同)vegetable_marrow
having bones as specified; "his lanky long-boned body"
having had the bones removed; "a boneless rib roast"; "a boned (or deboned) fish" (同)deboned
a percussion instrument consisting of a pair of hollow pieces of wood or bone (usually held between the thumb and fingers) that are made to click together (as by Spanish dancers) in rhythm with the dance (同)castanets, clappers, finger cymbals

PrepTutorEJDIC

〈C〉『くぼ地』,くぼみ / 〈U〉〈C〉『意気消沈』,憂うつ;うつ病 / 〈C〉『不景気』,不況 / 〈U〉押し下げること,降下,低下
〈C〉骨 / 〈U〉骨を作っている物質,骨質 / 《複数形で》骨格;死骸(がい) / 〈魚など〉‘の'骨を取る
髄(ずい),骨髄 / 精髄,粋 / 力,活力
(魚など)骨を取り除いた / (衣服が)(コルセットなどで)骨で張りをつけた[ような]

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/07/25 08:59:51」(JST)

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Bone marrow suppression or myelotoxicity (adjective myelotoxic) or myelosuppression is the decrease in production of cells responsible for providing immunity (leukocytes), carrying oxygen (erythrocytes), and/or those responsible for normal blood clotting (thrombocytes).^[1] Bone marrow suppression is a serious side effect of chemotherapy and certain drugs affecting the immune system such as azathioprine.^[2] The risk is especially high in cytotoxic chemotherapy for leukemia.

Non-steroidal anti-inflammatory drugs, in some rare instances, may also cause bone marrow suppression. The decrease in blood cell counts does not occur right at the start of chemotherapy because the drugs do not destroy the cells already in the bloodstream (these are not dividing rapidly). Instead, the drugs affect new blood cells that are being made by the bone marrow.^[3] When myelosuppression is severe, it is called myeloablation.^[4]

Because the bone marrow is the manufacturing center of blood cells, the suppression of bone marrow activity causes a deficiency of blood cells. This condition can rapidly lead to life-threatening infection, as the body cannot produce leukocytes in response to invading bacteria and viruses, as well as leading to anaemia due to a lack of red blood cells and spontaneous severe bleeding due to deficiency of platelets.

Parvovirus B19 inhibits erythropoiesis by lytically infecting RBC precursors in the bone marrow and is associated with a number of different diseases ranging from benign to severe. In immunocompromised patients, B19 infection may persist for months, leading to chronic anemia with B19 viremia due to chronic marrow suppression.^[5]

Thiazide diuretics can also lead to bone marrow suppression as an adverse effect.

Treatment

Bone marrow suppression due to azathioprine can be treated by changing to another medication such as mycophenolate mofetil (for organ transplants) or other disease-modifying drugs in rheumatoid arthritis or Crohn's disease.

Chemotherapy induced myelosuppression

Bone marrow suppression due to anti-cancer chemotherapy is much harder to treat and often involves hospital admission, strict infection control, and aggressive use of intravenous antibiotics at the first sign of infection.^{[citation needed]}

G-CSF is used clinically (see Neutropenia) but tests in mice suggest it may lead to bone loss.^[6]^[7]

GM-CSF has been compared to G-CSF as a treatment of chemotherapy-induced myelosuppression/Neutropenia.^[8]

Prediction

In developing new chemotherapeutics, the efficacy of the drug against the disease is often balanced against the likely level of myelotoxicity the drug will cause. In-vitro colony forming cell (CFC) assays using normal human bone marrow grown in appropriate semi-solid media such as ColonyGEL have been shown to be useful in predicting the level of clinical myelotoxicity a certain compound might cause if administered to humans.^[9] These predictive in-vitro assays reveal effects the administered compounds have on the bone marrow progenitor cells that produce the various mature cells in the blood and can be used to test the effects of single drugs or the effects of drugs administered in combination with others.

References

^ "bone marrow suppression". Retrieved 3 May 2011.
^ Azathioprine side effects
^ Bone marrow suppression
^ Dictionary of Cancer Terms: myelosuppression
^ Parvovirus B19 - BASICS
^ Researchers urge monitoring of bone health during chemotherapy.
^ Hirbe AC, Uluçkan O, Morgan EA, Eagleton MC, Prior JL, Piwnica-Worms D, Trinkaus K, Apicelli A, Weilbaecher K (April 2007). "Granulocyte colony-stimulating factor enhances bone tumor growth in mice in an osteoclast-dependent manner". Blood 109 (8): 3424–31. doi:10.1182/blood-2006-09-048686. PMC 1852257. PMID 17192391.
^ Beveridge RA, Miller JA, Kales AN, et al. (1998). "A comparison of efficacy of sargramostim (yeast-derived RhuGM-CSF) and filgrastim (bacteria-derived RhuG-CSF) in the therapeutic setting of chemotherapy-induced myelosuppression". Cancer Invest. 16 (6): 366–373. doi:10.3109/07357909809115775. PMID 9679526.
^ predicting-drug-induced-myelotoxicity

UpToDate Contents

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4. 成人における抗癌剤の投与 dosing of anticancer agents in adults
5. 小児や青年のホジキンリンパ腫の概要 overview of hodgkin lymphoma in children and adolescents

English Journal

Impaired postoperative leucocyte counts after preoperative radiotherapy for rectal cancer in the Stockholm III Trial.

Pettersson D, Glimelius B, Iversen H, Johansson H, Holm T, Martling A.SourceDepartment of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden.
The British journal of surgery.Br J Surg.2013 Jun;100(7):969-75. doi: 10.1002/bjs.9117. Epub 2013 Apr 2.
BACKGROUND: Radiotherapy (RT) in rectal cancer increases postoperative morbidity. A suggested reason is RT-induced bone marrow depression resulting in impaired leucocyte counts. The ongoing Stockholm III Trial randomizes patients with operable rectal cancers to short-course RT with immediate surgery
PMID 23553796

Evaluation of the cytotoxicity, mutagenicity and antimutagenicity of a natural antidepressant, Hypericum perforatum L. (St. John's wort), on vegetal and animal test systems.

Peron AP, Mariucci RG, de Almeida IV, Düsman E, Mantovani MS, Vicentini VE.SourceDepartment of Biotechnology, Genetics and Cell Biology, State University of Maringá, Maringá, Paraná, Brazil. lisdusman@yahoo.com.br.
BMC complementary and alternative medicine.BMC Complement Altern Med.2013 May 6;13:97. doi: 10.1186/1472-6882-13-97.
BACKGROUND: St. John's wort (Hypericum perforatum L.) is an herbaceous plant that is native to Europe, West Asia and North Africa and that is recognized and used worldwide for the treatment of mild and moderate depression. It also has been shown to be therapeutic for the treatment of burns, bruises
PMID 23647762

Fluoxetine Reduces Murine Graft-Versus-Host Disease by Induction of T cell Immunosuppression.

Gobin V, Van Steendam K, Fevery S, Tilleman K, Billiau AD, Denys D, Deforce DL.SourceLaboratory of Pharmaceutical Biotechnology, Faculty of Pharmaceutical Sciences, University of Ghent, Harelbekestraat 72, 9000, Ghent, Belgium.
Journal of neuroimmune pharmacology : the official journal of the Society on NeuroImmune Pharmacology.J Neuroimmune Pharmacol.2013 May 4. [Epub ahead of print]
Serotonin reuptake inhibitors (SRIs) are widely used drugs in the treatment of depression and anxiety disorders. Although SRIs are generally regarded as safe drugs with relatively few side effects, literature suggests that high concentrations of SRIs may alter immune function. We investigated whethe
PMID 23640520

Japanese Journal

Spontaneous and bilateral necrosis of the femoral head in a young experimental beagle dog

Kobayashi Ryosuke,Kurotaki Tetsuro,Yamada Naoaki,Kumabe Shino,Doi Takuya,Wako Yumi,Tsuchitani Minoru
Journal of Toxicologic Pathology 28(2), 121-124, 2015
… Microscopically, a wide range of trabecular bone necrosis localized in the subchondral area was observed in both femoral heads. … The bone marrow adjacent to the affected area showed severe depression. … In the metaphysis, atrophic bone marrow, but not bone necrosis, was observed. …
NAID 130005072420

Spontaneous and bilateral necrosis of the femoral head in a young experimental beagle dog

KOBAYASHI Ryosuke,KUROTAKI Tetsuro,YAMADA Naoaki,KUMABE Shino,DOI Takuya,WAKO Yumi,TSUCHITANI Minoru
Journal of Toxicologic Pathology advpub(0), 2015
… Microscopically, a wide range of trabecular bone necrosis localized in the subchondral area was observed in both femoral heads. … The bone marrow adjacent to the affected area showed severe depression. … In the metaphysis, atrophic bone marrow, but not bone necrosis, was observed. …
NAID 130004842626

骨髄穿刺で診断しえた骨シンチグラフィ陰性肝細胞癌骨髄癌症の1例

小池和彦,伊坪真理子,田尻久雄
肝臓 55(12), 740-748, 2014
症例は62歳男性．5年にわたるB型肝炎ウイルス関連肝細胞癌に対する繰り返す肝動脈塞栓術（TACE）の経過中，多発するリンパ節および骨転移を認めたためソラフェニブを導入したが，まもなく食欲不振，全身倦怠感が出現，内服中止後も改善がみられず入院となった．入院時身体所見として出血傾向を伴い，血液検査では血小板数低下，FDP 276 μg/mlまでの上昇など播種性血管内凝固症候群の徴候がみられ，末梢血への …
NAID 130004897334