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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. In the case of non-small-cell lung cancer, myelosuppression predisposition was shown to be modulated by enhancer mutations. [3]
The incidence of bone marrow failure is triphasic: one peak at two to five years during childhood (due to inherited causes), and two peaks in adulthood, between 20 and 25 years old and after 60 years old (from acquired causes). [14] One in ten individuals with bone marrow failure have unsuspected Fanconi anemia (FA). [14]
MDS after exposure to radiation or alkylating agents such as busulfan, nitrosourea, or procarbazine, typically occurs 3–7 years after exposure and frequently demonstrates loss of chromosome 5 or 7. MDS after exposure to DNA topoisomerase II inhibitors occurs after a shorter latency of only 1–3 years and can have a 11q23 translocation.
Red blood cells normally survive an average of about 120 days, becoming damaged (their oxygen-carrying capacity becomes compromised) as they age.
In chemotherapy as a conditioning regimen in hematopoietic stem cell transplantation, a study of people conditioned with cyclophosphamide alone for severe aplastic anemia came to the result that ovarian recovery occurred in all women younger than 26 years at time of transplantation, but only in five of 16 women older than 26 years.
Anemia must be significant before a person becomes noticeably pale. [1] Additional symptoms may occur depending on the underlying cause. [1] Anemia can be temporary or long term and can range from mild to severe. [6] Anemia can be caused by blood loss, decreased red blood cell production, and increased red blood cell breakdown. [1]