In myelosuppression (bone marrow suppression), your bone marrow doesn’t make enough blood cells or platelets. Myelosuppression increases your risk of blood disorders like anemia or infections and bleeding issues. Most people have myelosuppression because they’re receiving chemotherapy. But certain viruses and blood cancers can also cause myelosuppression.
Myelosuppression (bone marrow suppression) happens when something affects your bone marrow so it doesn’t work as it should.
Bone marrow is the soft spongy tissue inside your bones. Every day, it produces and releases billions of red blood cells, white blood cells and platelets that you need to survive. Your blood cells and platelets support your overall health in different ways. Your bone marrow adjusts its production based on your body’s changing needs.
In myelosuppression, something interferes with that production process. Chemotherapy to treat cancer is the most common reason, but some blood cancers and viruses may also affect your bone marrow’s ability to make the right number of blood cells and platelets.
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
Myelosuppression symptoms may vary depending on how it affects your blood cells and platelets. Your red blood cells, white blood cells and platelets support your body in different ways. When your bone marrow doesn’t make enough red blood cells or platelets, you may develop certain blood disorders such as anemia or thrombocytopenia. If your white blood cell levels are low, you may have an increased risk of infection.
Anemia happens when you don’t have enough red blood cells. Your red blood cells carry oxygen throughout your body. Anemia symptoms include:
Myelosuppression may keep your bone marrow from making enough neutrophils, a white blood cell that destroys germs that cause infections. People with lower-than-normal neutrophil levels have neutropenia. Neutropenia doesn’t cause symptoms, but the infections that may result from having neutropenia can. Repeated infections may also be a sign of neutropenia. Symptoms of infection may include:
Platelets help control bleeding. People with low platelet levels have thrombocytopenia. Thrombocytopenia symptoms include:
When blood cell and platelet levels are all low, you have pancytopenia. Like neutropenia, pancytopenia isn’t a disease but it may be a sign of underlying conditions.
Chemotherapy to treat cancer is the most common cause. But some blood cancers and certain viruses can affect your bone marrow and cause myelosuppression.
Several chemotherapies may cause myelosuppression, but the most common include:
CAR T-cell therapy, which is a type of immunotherapy, may affect your bone marrow so it produces fewer blood cells and platelets.
Blood cancers can interrupt normal blood cell production. In blood cancers such as leukemia, lymphoma and myeloma, abnormal blood cells multiply in your bone marrow and keep it from producing healthy blood cells and platelets.
Viruses may cause myelosuppression by disrupting the blood cell production process. Your body fights intruders, including viruses, by rallying white blood cells that destroy intruders. When that happens, your bone marrow may make fewer red blood cells and platelets. Some research suggests certain viruses may infect blood-forming cells in your bone marrow and lower blood cell levels. Experts have linked the following viruses to myelosuppression:
Myelosuppression may cause life-threatening complications such as acute anemia or uncontrollable bleeding.
Healthcare providers diagnose this condition with blood tests to determine if your bone marrow is producing normal numbers of blood cells and platelets.
Blood tests may include:
Healthcare providers treat myelosuppression by:
Myelosuppression usually happens during cancer treatment. Healthcare providers take steps to reduce the risk of myelosuppression by carefully monitoring treatment side effects, including myelosuppression.
Most people develop myelosuppression because they’re receiving chemotherapy. If that’s your situation, your healthcare provider will carefully monitor how chemotherapy affects your bone marrow. You may have to take a brief break from cancer treatment while your bone marrow builds up blood cell levels.
Myelosuppression may increase your risk of infection and bleeding. You may be able to reduce that risk by:
You may want to ask your provider the following questions:
A note from Cleveland Clinic
Your bone marrow — the soft spongy tissue inside your bones —is an essential part of your body. It produces red blood cells that carry oxygen, white blood cells that prevent infection and platelets that control bleeding. In myelosuppression, something prevents your bone marrow from doing its job. The most common cause is chemotherapy to treat cancer, but you may also develop myelosuppression if you have certain blood cancers or viruses. Healthcare providers treat myelosuppression by determining what’s keeping your bone marrow from its work and then managing the cause.
Last reviewed by a Cleveland Clinic medical professional on 02/27/2023.
Learn more about our editorial process.
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy