The physiologic evaluation and management of chronic bone marrow failure

1. 1. Physiologic technics are available which permit evaluation of the relative importance of inadequate production and increased destruction of red blood cells in the pathogenesis of a given anemia. 2. 2. Data derived from these technics have been applied to the clinical management of ten patients with chronic bone marrow failure. 3. 3. The anemia of chronic bone marrow failure is due to decreased production of red blood cells and may be associated with a hemolytic component. 4. 4. Erythropoiesis in some patients may be stimulated by the administration of adrenocorticotrophic hormone or cortisone. Evidence is presented to suggest that it is these patients who are most likely to respond favorably to splenectomy. If a hemolytic component is also present, splenectomy tends to correct the abnormal red cell destruction. 5. 5. The anemia of chronic bone marrow failure should not be considered entirely refractory to therapy.