Hematopoietic System

Bone Marrow

The Hematopoietic system is

responsible for the formation and
functioning of blood elements
(Mosbys, 2008)

The tissues and organs involved

include the bone marrow, circulating
blood, lymph nodes, spleen, and
thymus.
(Travis, 1989, p. 113)

Bone Marrow

There are 2 different types of bone

marrow found in our body
Red and Yellow

At birth, all marrow is red, but as we age

approximately half turns to yellow

Red marrow is primarily found in flat

bones such as the hips, sternum, skull,
shoulder blades, and at the proximal
ends of the femur and humerus
(Science Daily, n.d., para. 6-9)

Bone Marrow

There are 2 different stem cells found

in bone marrow
Hemopoietic, which produces blood cells
Stromal, which produces fat, cartilage, &
bone
(Science Daily, n.d.,
para, 2)

Yellow marrow consists mainly of fat

cells and is not active in supplying
circulating blood with mature cells
(Travis, 1989, p. 114)

(Sicklecellbodypolitics.com)

Erythrocytes
Production of an erythrocyte takes 4
days
The average life span is 120 days
They mature in 24 hours of circulation
2-3 million are released per second
Erythroblasts are the youngest RBCs

Most radiosensitive
Numbers will return to normal approximately
one week after a moderate dose
(Travis, 1989, p. 115)

Leukocytes

Production take 3-10 days

5 different types of Leukocytes
Lifespan ranges from 30 minutes to years
Make up only 1% of total blood volume
Myelocytes are precursors to 3 types of
WBCs
Second most radiosensitive
Numbers take 2-6 weeks
after a moderate dose to
recover
(Travis, 1989, p. 115)

Platelets
Production take approximately 5 days
Average lifespan is about 10 days
Derived from Megakaryocytes

Least radiosensitive
Mitotic delay occurs 1-2 weeks post
exposure with a 2-6 week recovery time
(Travis, 1989, p. 115)

Dose

The lowest radiation dose resulting in

observable bone marrow depression that
causes a reduction of blood counts is
.1-.5 Gy (.001-.005 cGy)
(Dainiak, 2012, para. 18)

For doses greater than .7 Gy (.007 cGy),

bone marrow suffers more acute
symptoms
(CDC, 2006, Table 1)

Current standard dose for Respiratory

System tumors is between 4500 5400
cGy at 180 200 cGy fractions. For
Colorectal cancer the standard treatment
dose ranges from 4500 cGy to 5500 cGy
(W&L, 2010, p. 675, 773)

Dose

After doses greater than .7 Gy the

patient may suffer from Hematopoietic
Syndrome. There are 4 stages:
Prodromal Stage Patient suffers from
nausea, diarrhea, and anorexia beginning
from one hour to 2 days post treatment and
last for days.
Latent Stage - Patient appears and feels
well, but the stem cells in the bone marrow
are dying. Lasts 1-6 weeks
Manifest Illness Stage Physical symptoms
appear
Recovery or Death

References

Acute radiation syndrome: a fact sheet for physicians. (2006,

May 10). In Emergency preparedness and response.
Retrieved June 16, 2013, from Centers for Disease Control
and Prevention website:
http://www.bt.cdc.gov/radiation/arsphysicianfactsheet.asp
Bone Marrow. (n.d.). In Sciencedaily. Retrieved June 16,
2013, from ScienceDaily, LLC website:
http://www.sciencedaily.com/articles/b/bone_marrow.htm
Dainiak, N. (2012, October 23). Biology and clinical features
of radiation injury in adults. In Uptodate. Retrieved June 16,
2013, from Wolters Kluwer website:
http://www.uptodate.com/contents/biology-and-clinicalfeatures-of-radiation-injury-in-adults
LaTorre Travis, E. (1989). Medical radiobiology (K. Kelly, Ed.,
Second). Chicago, IL: Year Book Medical Publishers, Inc.
Washington, C., & Leaver, D. (2010). Principles and practice
of radiation therapy (J. Olson, Ed., Third). St. Louis, Missouri:
Mosby Elsevier.