Patient education: Managing bone marrow suppression from your medicines (The Basics)

What is bone marrow suppression? — 

This is when the bone marrow isn't making enough blood cells. Bone marrow is the spongy, center part of some bones. It makes all the cells in the blood, such as red blood cells ("RBCs"), white blood cells ("WBCs"), and platelets. Bone marrow is part of the immune system, which is the body's infection-fighting system.

When your bone marrow is suppressed, you might:

●Feel very tired and weak

●Bleed more easily than normal

●Get sick from infections more easily than normal

Which medicines can cause bone marrow suppression? — 

When a medicine causes bone marrow suppression, it is called a "side effect."

You might have problems with bone marrow suppression if you take medicines to treat conditions like:

●Cancer

●Seizures

●Transplant rejection

●Arthritis

●Mental health problems

●HIV

●Infections

If your medicine is causing bone marrow suppression or other side effects, ask your doctor or nurse if you can switch to another medicine instead. But do not stop taking any medicine without talking to them first.

How is bone marrow suppression treated? — 

Treatment depends on which of your blood cells are low. For example:

●If your RBCs are low, you might need a blood transfusion.

●If your WBCs are low, the doctor might prescribe medicines to treat or prevent an infection.

●If your platelet count is low, you might need a platelet transfusion.

●Your doctor might prescribe medicines to help your body build more RBCs or WBCs.

What can I do on my own? — 

If your medicine is causing bone marrow suppression, your body has a harder time fighting infections.

To help lower your risk of infection:

●Wash your hands often. Use soap and water for at least 20 seconds (figure 1). If soap and water are not available, use alcohol-based hand sanitizers with at least 60 percent alcohol. Rub your hands with the sanitizer for at least 20 seconds (figure 2).

Always clean your hands:

•Before eating

•Before preparing food

•After coughing or sneezing

•After using the bathroom or changing a diaper

•After touching an animal

•After touching surfaces with a lot of germs, like elevator buttons, remotes, and light switches

●Avoid touching your nose, eyes, and mouth. Germs most often enter the body through these parts.

●Do not share towels, tissues, food, or drinks with anyone who is sick.

●Get the vaccines your doctor recommends.

●Avoid crowds during flu season or when COVID-19 cases are high. This will lower you chance of being around other people who might be sick.

●Pay attention to food safety:

•Do not drink unpasteurized milk or foods made with it.

•Wash fruits and vegetables well before eating them.

•Keep the refrigerator colder than 40°F (4.4°C) and the freezer colder than 0°F (-18°C).

•Cook meat and seafood until well done.

•Cook eggs until the yolk is firm.

•Wash hands, knives, and cutting boards after they touch raw food.

You can also talk to your doctor or dietitian about foods that might help you keep up your blood cell counts.

When should I call the doctor? — 

Call for advice if you:

●Have a fever of 100.4°F (38°C) or higher, or chills

●Feel very tired or like you have no energy

●Have new or unusual bruising or bleeding

●Have heavy menstrual periods, or spotting or bleeding between periods

●Have other symptoms that also worry you (like bleeding, weakness, weight loss, or fever)

More on this topic

Patient education: Side effects from medicines (The Basics)
Patient education: Complete blood count (CBC) (The Basics)
Patient education: Blood transfusion (The Basics)
Patient education: Lowering the risk of spreading infection (The Basics)
Patient education: How to wash your hands (The Basics)