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Bone Marrow Suppression and Chemotherapy

The side effects of chemotherapy (chemo) depend on the type of chemo. They also depend on the amount given. Side effects can be planned for and managed. This will help reduce them and give the best possible experience for the person getting chemo.

Each person's health and diagnosis are different. Their reaction to treatment is different, too. You may not have side effects. Or they may be mild or severe. Talk with your cancer care team about the possible side effects of treatment before the treatment starts.

What is bone marrow suppression?

Bone marrow is soft, spongy tissue in the middle of certain bones. It makes blood cells. Nearly all chemo medicines suppress the bone marrow. This causes the marrow to make fewer blood cells. The timing of this effect varies by the medicines used and the doses used for your treatment.

Bone marrow makes red blood cells, white blood cells, and platelets. Red blood cells carry oxygen to all the cells in the body. White blood cells fight infection. Platelets help control bleeding and bruising. The risks for anemia (low red blood cells), severe tiredness (fatigue), infection, bleeding, and bruising go up when your bone marrow is suppressed.

What are the symptoms of bone marrow suppression?

These are the most common symptoms of bone marrow suppression. But symptoms may be a bit different for each person.

Symptoms of a low red blood cell count may include:

  • Fatigue

  • Pale skin, lips, and nail beds

  • Faster heart rate

  • Easy tiring with exertion

  • Dizziness

  • Shortness of breath

Symptoms of a low white blood cell count only happen if an infection occurs because of the low count. These may include:

  • Fever and chills

  • Mouth sores 

  • Rash

  • Diarrhea

  • Swelling

  • Redness

  • An area that is warm to touch

Symptoms of a low platelet count may include:

  • Easy bruising

  • Bleeding through nosebleeds, or from the gums or mouth

  • Tiny red spots on the skin

  • Blood in the urine

  • Dark or black bowel movements

The symptoms of bone marrow suppression may seem like other health problems. Always talk with your healthcare provider for a diagnosis.

Medical Reviewers:

  • Jessica Gotwals RN BSN MPH
  • Ronald Karlin MD
  • Todd Gersten MD