Understanding Bone Marrow Disorders in Children: Causes & Treatments

Childhood bone marrow disorders can either be inherited or occur randomly. These disorders can be treated, but require thorough medical testing.

Bone Marrow Should Be a Child's Defense Against Danger

• All blood cells come from stem cells in bone marrow.

  Children, like adults, need infection protection. Healthy bone marrow, the spongy substance inside our bones, produces three critical cells:
  • Infection-fighting white blood cells
  • Oxygen-carrying red blood cells
  • Platelets, which stop bleeding by causing blood to clot.
  When a child's marrow doesn't create enough of these, the failure can lead to diseases.

Bone Marrow Disorders Can Be Inherited

• In some cases, bone marrow disorders are passed down in families. Hereditary bone marrow abnormalities include:
  • Fanconi anemia, a rare disease in which blood stem cells in bone marrow collect damaged DNA
  • Shwachman-Diamond syndrome (SDS), a condition that usually affects the bone marrow, pancreas and skeleton.

Bone Marrow Disorders Can also be Acquired

• Some childhood bone marrow failures are caused by unknown factors and may occur randomly. Acquired bone marrow disorders include:
  • Aplastic anemia, in which lower numbers of red blood cells cause levels of hemoglobin, a blood system oxygen-carrier, to drop. White cell counts also drop, leaving the patient open to infections, and fewer blood platelets cause blood clotting problems.
  • Myelodysplastic syndrome, a condition that kills many of a child's produced blood cells and destroys them before they can leave the marrow.

Diagnosing Bone Marrow Disorders

• Medical teams at Seattle Children's Hospital follow these steps to diagnose children's bone marrow disorders:
  • Take a detailed health history
  • Examine children for signs of illness
  • Do blood tests to check the level of each kind of blood cell and study the cells under a microscope
  • Remove a sample of bone marrow (called bone marrow aspiration or biopsy) and test the marrow sample

When Is It Time for a Transplant?

• The National Marrow Donation Program says bone marrow or umbilical cord blood transplants may offer the best option for curing a child's bone marrow disorder. In general, patients respond best to transplants when:
  • Their disease process is in its early stages
  • When the disease is in remission or there is very little disease in the body
  • When the disease is sensitive to chemotherapy
  • When the children are in good overall health and their organs work well