J.R. breezed confidently into the exam room, snapping her gum and chatting up a storm about pedicures with the nurse. By all accounts, she looked like your typical high school cheerleader: ponytail, muscular legs and a quick smile.J.R.’s parents brought her to the doctor’s office because she’d complained of feeling unusually tired during cheer practice over the past couple of weeks. Other than that, she insisted that she felt fine. Her bright demeanor suggested excellent health. The doctor figured that J.R., like many teenaged girls, was probably anemic. She ran a few tests to check for anemia and for a common viral illness called mono.When J.R.’s blood test results came back, the doctor stared at them for few minutes in disbelief. The nurse walked into the doctor’s office and saw the doctor sitting there motionless at her desk, jaw agape and eyes wide, staring at the computer screen.“Oh shit,” the nurse exclaimed. “It must be really bad.”And it was. J.R.’s white blood cell (WBC) count was through the roof. A normal WBC count doesn’t usually exceed 10. An elevated WBC count, such as 25, suggests infection. But a WBC count approaching 100 suggests leukemia, or a relatively rare type of cancer in which white blood cells undergo uncontrolled proliferation. An extremely elevated WBC count like this is a medical emergency, since the increased concentration of white cells in the blood stream can clog up small vessels like those in the kidney and brain. The doctor called J.R.’s parents. She told them about J.R.’s elevated WBC count, and instructed them to take their daughter to the emergency room immediately. She hung up the phone with a heavy heart and cradled her head in her hands. After the emergency room, J.R. would be hospitalized. She would undergo chemotherapy and radiation to kill off the cancerous white blood cells. Eventually, she would need a bone marrow transplant to help repopulate her body with healthy blood cells.●●●Mother Nature, in her infinitely creative wisdom, decided to utilize the snug, protected space inside of our bones as a nursery for newborn blood cells. Blood cell birth occurs in the bone marrow, or the spongy tissue inside our bones. There are two different types of bone marrow: red and yellow. Red bone marrow produces blood cells, and yellow bone marrow is composed mainly of fat cells. At birth, all bone marrow is red. As we age, some red bone marrow (such as the marrow inside the long bones of our legs) is replaced with yellow marrow. About half of adult marrow is red, typically found in flat bones like those of the hip and shoulder blade.●●●A bone marrow transplant involves eliminating the recipient’s cancerous blood-forming cells and replacing them with healthy donor cells. The recipient and the donor must have compatible tissue types. Unfortunately, no one in J.R.’s family was found to be a compatible match. J.R. and her family clung to fervent, anxious hope that her doctors would find her a match in the bone marrow donor registry. After several extremely tense weeks, J.R.’s doctors identified an appropriate donor. Several weeks after that, an extremely ill J.R. received a life-saving gift of healthy marrow cells from a total stranger. These days, most bone marrow donation procedures are not all that different from a simple blood donation. If you register to donate marrow and are selected as a donor, you’ll be give drugs for a few days that tell your bone marrow to increase its productivity and churn a bunch of health new cells out into your circulatory system. These cells are then collected through a needle that goes into a vessel in your arm. Some patients, like children or those with certain types of leukemia, fare better with a more traditional bone marrow transplant, in which donor marrow is harvested directly from the hip bone. If you donate this way, you’ll be numbed up before a doctor inserts a special needle into your hipbone to withdraw marrow cells.Both procedures are minimally invasive with a very low risk of complications. If you are interested in joining the national marrow donation registry, visit marrow.org for more information. I joined a few days ago, and it was easy breezy. The registry is especially in need of participants who belong to ethnic minority groups, such as Hispanics, Native Americans and African Americans.
Vitals And Bits #8: Bone Marrow
4 min read
