If granulocytosis is due to cancer, your healthcare provider may recommend chemotherapy, radiation therapy or a bone marrow transplant. (2020). Hemoglobin also removes carbon dioxide (CO2), which is a waste product of respiration, and sends it back to the lungs for exhalation. The contents of these cells are released into the blood. Oxygen turns into energy, and your tissues release carbon dioxide. Lymph contains red blood cells. A healthcare professional then obtains a blood sample and isolates stem cells for microscopic examination. Lymph is transported through a network of increasingly larger lymphatic passageways. For this reason, experts have typically advised against undergoing transplantation after this age. Yellow marrow produces fat, cartilage, and bone and is found in the central portion of long bones. Which would be the route taken by lymph traveling from lymphatic vessels in the right leg to the bloodstream? What structure is indicated by number 4? Yellow bone marrow tends to be located in the central cavities of long bones and is generally surrounded by a layer of red bone marrow with long trabeculae (beam-like structures) within a sponge-like reticular framework. Unlike other cells of the body, mature red blood cells do not contain a nucleus, mitochondria, or ribosomes. Theyll then use a thin needle (21 gauge, slightly smaller than the size of a standard earring) to withdraw a small amount of blood from a vein in your arm. Red blood cells transport oxygen to cells and tissues, platelets travel in the blood to help clotting after injury, and white blood cells travel to sites of infection or injury. Edit Report an issue 30 seconds. . What is the latest research on the form of cancer Jimmy Carter has? Leukemia, Hodgkin disease, and other lymphoma cancers can damage bone marrows productive ability and destroy stem cells. To check if the tissue type is compatible, doctors assess how many proteins match on the surface of the donors and recipients blood cells. The blood vessels act as a barrier to prevent immature blood cells from leaving bone marrow. 3 In these cases, immature granulocytes indicate a healthy bone marrow response and it's not a cause for concern.). epiphysis/metaphysis of long bone (children only) Function. This is a normal and appropriately high level of EPO. In humans the red bone marrow forms all of the blood cells with the exception of the lymphocytes, which are produced in the marrow and reach their mature form in the lymphoid organs. Graft-versus-host-disease (GVHD). The most common treatment to directly correct anemia due to low EPO levels is recombinant erythropoietin (erythropoietin-stimulating agents or ESAs). It is these blood stem cells, rather than bone marrow itself, that are necessary for the treatment of blood cancers and other conditions. Even if your EPO levels are within a normal range, you may still require treatment. Conditions that may be treatable with a bone marrow transplant include both cancerous and noncancerous diseases. Bone Marrow. D) Connective tissue bands called tendineae divide nodes, B) The axillary lymph nodes receive lymph from the breast and may contain cancer cells. 1.Introduction. Return to work. This versatility allows embryonic stem cells to be used to regenerate or repair diseased tissue and organs. There are two types of bone marrow: red and yellow. A biopsy can help diagnose anemia and some types of cancer. Your EPO test results may vary according to several factors, including your: Your healthcare provider will carefully interpret your results and let you know if your levels are healthy or out of range. (n.d.). We do not endorse non-Cleveland Clinic products or services. To be listed in the registry, potential donors must be healthy and aged 1860 years. Blood cells have a limited life span. Cancerous diseases may or may not specifically involve blood cells, but cancer treatment can destroy the bodys ability to manufacture new blood cells. It is particularly useful in providing information on various stages of immature blood cells. The thoracic duct collects lymph from all of the following except the, The thoracic duct and the right lymphatic duct empty lymph into the, B) Right lumbar trunk - cisterna chyli - thoracic duct - left subclavian vein. A healthcare professional usually inserts a needle into the hip or sternum in adults or into the upper part of the tibia (the larger bone of the lower leg) in children. Blood vessels within this tissue deliver nutrients to osteocytes and remove waste. Which is not correct regarding the spleen? Theyll send your blood sample to a lab for analysis. They write new content and verify and edit content received from contributors. Bone marrow is a soft, fatty tissue inside the center of the bones, where blood cells are made. At birth and until about the age of seven, all human marrow is red, as the need for new blood formation is high. Donors never pay for donating, and they are never paid to donate. Once the lab finishes testing your blood sample, a healthcare provider will contact you to discuss your test results and answer any questions. A bone marrow transplant is a specialized procedure in which healthy stem cells are infused into the blood. Yellow bone marrow, on the other hand, is mostly composed of fat cells and does not produce blood cells. The skeletal system provides support for your body, gives your body shape (both of which assist movement), and protects your body organs from injury's. Bones contain marrow which helps produce red . This may happen when the oxygen content of body tissues is low, if there is loss of blood or anemia, or if the number of red blood cells decreases. Bone marrow also produces and releases more white blood cells in response to infections and more platelets in response to bleeding. High-dose chemotherapy and stem cell transplant for testicular cancer. The Glickman Urological & Kidney Institute offers innovative treatments in urology and kidney medicine, including minimally invasive, scarless options for urologic procedures and medical management of kidney disease. Mattson, J. This can be acute or chronic and may manifest as a rash, a gastrointestinal illness, or liver disease. With respect to the lymphatic system, what do the letters in the acronym MALT stand for? The incisions do not usually require stitches. controls the inner diameter of bone. As children, nearly all of our bones contain red bone marrow, but this gradually gets replaced by yellow marrow as we grow older. Only mature blood cells contain the membrane proteins required to attach to and pass through the blood vessel endothelium. In which abdominal quadrant is the spleen located? It requires anesthetics and is, therefore, completely painless. It can regenerate a new immune system that fights existing or residual leukemia or other cancers that. Coming to a Cleveland Clinic location?Hillcrest Cancer Center check-in changesCole Eye entrance closingVisitation, mask requirements and COVID-19 information, Notice of Intelligent Business Solutions data eventLearn more. red bone marrow. They then insert special, hollow needles into the bone, through which they draw the liquid marrow. Advertising on our site helps support our mission. Leukocytes. Long bones contain yellow bone marrow and red bone marrow, which produce blood cells. Granulocytosis may be a symptom of several conditions, including chronic myelogenous leukemia (CML), primary thrombocythemia, polycythemia vera and primary myelofibrosis. Because of the danger of this complication, autologous transplants are more common. The following are some general guidelines for bone marrow donation as recommended by the NMDP. You'll get a detailed solution from a subject matter expert that helps you learn core concepts. Each type of granulocyte has its own combination of chemicals and enzymes in its granules. Articulations. Erythropoietin (ih-rith-roh-POY-uh-tin) is a hormone that your kidneys primarily produce. Autologous products are almost always cryopreserved. One of the functions of the lymphatic system is to transport fat. $KN O_3$. This is useful in conditions such as leukemia, aplastic anemia, and sickle cell anemia. Granulocytes form in the bone marrow and release into the bloodstream when necessary. It involves a number of different cells with a variety of functions. We link primary sources including studies, scientific references, and statistics within each article and also list them in the resources section at the bottom of our articles. Cleveland Clinic Cancer Center provides world-class care to patients with cancer and is at the forefront of new and emerging clinical, translational and basic cancer research. Certain white blood cells mature in the lymph nodes, spleen, and thymus gland. A bone marrow transplant may completely or partially cure a condition. Platelets are necessary for blood to coagulate and for clots to form in order to stop bleeding. People with Lyme disease, malaria, or recent tattoos or piercings should wait at least a year before donating bone marrow. Red bone marrow is responsible for producing red blood cells, white blood cells, and platelets, which are important components of the blood. Hematopoietic stem cells can cross the bone marrow barrier, however. . Cancellous bone is located within compact bone. Both types of bone marrow are enriched with blood vessels and capillaries. It becomes active about 3 weeks later. They contain enzyme granules, which form in the cytoplasm (a thick, semi-fluid solution that fills each cell). Bone marrow produces platelets in a process known as thrombopoiesis. The pulsing of arteries that are adjacent to lymphatic vessels provides a pressure on the vessels that helps them propel the lymph. The production of healthy stem cells is vital. Policy. Get useful, helpful and relevant health + wellness information. They compare proteins in the blood cells to see if they are similar to those of the recipient. Location. Yellow bone marrow contains mesenchymal stem cells, or marrow stromal cells. This may be due to chronic smoking or living in a high-altitude environment where air oxygen levels are lower. Healthcare professionals may harvest these from peripheral, or circulating, blood. (n.d.). Coming to a Cleveland Clinic location?Hillcrest Cancer Center check-in changesCole Eye entrance closingVisitation, mask requirements and COVID-19 information, Notice of Intelligent Business Solutions data eventLearn more. . Or each student could take on certain tasks, such as researching all the foot adaptations and habitat information. Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. There are many different types of T cells, and they perform a range of functions as part of adaptive cell-mediated immunity. Your healthcare provider can run this routine blood test. The overall 3-year survival rate is 4958% for transplants from related donors or 53% if the donor is unrelated. Healthcare professionals perform several tests before a bone marrow transplant to identify any potential problems. thin membrane that lines spongy bone and all inner surfaces of bone; contains bone-forming cells. The number of lymphocytes increases in response to these invasions. Plan who will be responsible for which aspects of the guide. About 37.9 million potential donors and over 802,600 cord blood units were available as of April 2021. NK T cells recognize antigens presented in a different way from many other antigens, and they can perform the functions of T helper cells and cytotoxic T cells. This means that a relative is more likely to have a matching tissue type. If neutropenia is caused by a medication, then your provider will likely change your prescription. Normally, when specialized cells in your kidneys detect low blood oxygen levels, they increase the production of EPO. Which fluid does lymph most closely resemble? This article looks at everything there is to know about bone marrow. Bone marrow aspiration, the direct removal of a small amount (about 1 ml) of bone marrow, is accomplished by suction through a hollow needle. Significant risks include increased susceptibility to infection, anemia, graft failure, respiratory distress, and excess fluid, which can lead to pneumonia and liver dysfunction. A bone marrow transplant is useful for various reasons. When an individual joins a bone marrow donation registry, they are agreeing to donate using whichever method the healthcare professional deems appropriate. It can replace bone marrow with genetically healthy, functioning bone marrow to prevent further damage from a genetic disease process, such as Hurlers syndrome or adrenoleukodystrophy. 1 pt. Sudden blood loss triggers platelet activity at the site of an injury or wound. Once lymphocytes are made in bone marrow, they travel to the lymph nodes. They can determine the root cause of your condition and recommend appropriate treatment. Polycythemia vera is a type of blood cancer that causes your bone marrow to make too many red blood cells due to a genetic mutation. Red bone marrow also contributes, along with the liver and spleen, to the destruction of old red blood cells. As adults, red bone marrow is found mainly in the. Question: in an adult, which of the following is a bone that does not contain red bone marrow? Recipients with acute leukemia in remission at the time of transplant have an overall 1-year survival rate of 6975% if the donor is related or 68% if the donor is unrelated. If the transplant is successful, the person can go back to most regular activities as soon as they feel well enough. Bone marrow is soft, gelatinous tissue that fills the medullary cavities, or the centers of bones. Past studies suggest that people aged over 50 years have a higher risk of complications following bone marrow transplantation. Hematopoietic stem cells in the bone marrow give rise to two main types of cells: myeloid and lymphoid lineages. 9500 Euclid Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event. A bone marrow transplant is often the best chance for survival. These cells develop into red blood cells, white blood cells, or platelets. An introduction to bones. A persons tissue type is defined as the type of HLA they have on the surface of most of the cells in their body. Over 98.5% of donors make a full recovery after the procedure. ephysis and distal. In most cases, you cant prevent these conditions from occurring. Erythrocytes (red blood cells or RBCs) are anucleate, biconcave cells, filled with hemoglobin, that transport oxygen and carbon dioxide between the lungs and tissues.They are produced in the red bone marrow by a process called erythropoiesis. Do some laundry. Total number of donors and cord blood units. A high granulocyte count (granulocytosis) could indicate a number of issues, including infection, blood cell cancer or some type of autoimmune disease. For example, if infection resulted in granulocytosis, then your provider will prescribe antibiotics. Bone marrow replaces itself within 46 weeks. About every 3 minutes in the United States, someone receives a diagnosis of blood cancer. Even when a donor antigen match is identical, 2050% of recipients still develop GVHD, rising to 6080% when only a single antigen is mismatched. 2. Bone marrow is obtainable for examination by bone marrow biopsy and bone marrow aspiration. Around 30% of people can find a matching donor in their families, but 70% rely on bone marrow that someone unrelated has donated. A transplant can help rebuild the bodys capacity to produce blood cells and bring their numbers to acceptable levels. Fibrin has a thread-like structure and forms an external scab or clot. Before the transplant, the person may receive chemotherapy, radiation therapy, or both. Long bones are longer than they are wide and have a shaft and two ends. Which of the lymphatic trunks drain into the cisterna chyli? Donating peripheral blood stem cells. Before a person can donate PBSC, they need to undergo daily injections of a medication called filgrastim in the 5 days leading up to the procedure. Bone marrow contains immature cells called stem cells. We avoid using tertiary references. In around 96% of cases, the donor receives general anesthetics, which means that they are unconscious for the entire procedure. They can run tests to find the underlying cause and plan appropriate treatment. After entering the bloodstream, the hematopoietic stem cells travel to the bone marrow. These treatments tend to damage healthy stem cells as well as destroy cancer cells. MALT is found in which layer of the wall of a hollow organ? Q. The life span of a red blood cell is _____ 120 days. This is according to a 2015 report by the Worldwide Network for Blood and Marrow Transplantation. The sensitivity of marrow to damage by radiation therapy and some anticancer drugs accounts for the tendency of these treatments to impair immunity and blood production. E) No exceptions; all choices contain MALT, Regions of MALT called Peyer patches are found in the, Another name for a lymphatic follicle is a, B) lymphatic cells, extracellular matrix, and an incomplete connective tissue capsule. In most cases, there appears to be minimal toxicity. During childhood, most bones contain red bone marrow, but as we age, much of this marrow is replaced . Hematopoietic stem cell transplantation (HSCT) involves the intravenous (IV) infusion of stem cells collected from bone marrow, peripheral blood, or umbilical cord blood. If the root cause is an autoimmune disorder, then immunosuppressants such as prednisone may be given. They typically perform bone marrow aspiration when previous blood tests have indicated a need for it. The necessity for a bone marrow aspiration is ordinarily based on previous blood studies and is particularly useful in providing information on various stages of immature blood cells. peripheral blood, which is present in blood vessels throughout the body, tissue typing and a variety of blood tests, heart function tests, including an electrocardiogram and echocardiogram (ECG), genetic conditions relating to metabolism, such as mucopolysaccharidosis, Gauchers disease, metachromatic leukodystrophies, and adrenoleukodystrophies, some genetic immunologic or hematopoietic conditions. A) True B) False B) originate as closed-ended tubes associated with blood capillary networks Lymphatic capillaries A) cannot be discerned structurally from cardiovascular system capillaries. This eliminates the compromised marrow. Adults have an average of about 2.6 kilograms (kg) (5.7 pounds) of bone marrow, about half of which is red. While every effort has been made to follow citation style rules, there may be some discrepancies. The more similar the donors tissue type is to the individuals, the better the chance of the persons body accepting the transplant. Low red blood cell count B. Stem cells rapidly multiply to make millions of blood cells each day. A) True B) False B) False The central nervous system contains a dense network of lymphatic capillaries. You can learn more about how we ensure our content is accurate and current by reading our. The circulatory system touches every organ and system in the body. The authors of a 2013 report conclude that transplantation can be safe for people aged over 70 years, if they meet certain criteria. They use suction to extract the sample. As adults, red bone marrow is . in an adult, which of the following is a bone that does not contain red bone marrow? How Viagra became a new 'tool' for young men, Ankylosing Spondylitis Pain: Fact or Fiction, Hematopoietic stem cell transplantation (HSCT), National Marrow Donor Program (NMDP) guidelines, determine how well the new bone marrow is working, peripheral blood stem cell (PBSC) donation, https://bethematch.org/support-the-cause/donate-bone-marrow/after-you-donate/, https://ashpublications.org/blood/article/105/11/4215/19501, https://www.cancer.gov/about-cancer/treatment/types/stem-cell-transplant/stem-cell-fact-sheet, https://medlineplus.gov/lab-tests/bone-marrow-tests/, https://www.lls.org/managing-your-cancer/lab-and-imaging-tests/bone-marrow-tests, https://open.oregonstate.education/aandp/chapter/6-3-bone-structure/, https://pubmed.ncbi.nlm.nih.gov/23791626/, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5443590/, https://stemcells.nih.gov/info/Regenerative_Medicine/2006chapter2.htm, https://bethematch.org/support-the-cause/donate-bone-marrow/donation-process/donating-pbsc/, https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/stem-cell-transplant/donors.html, https://bethematch.org/patients-and-families/life-after-transplant/physical-health-and-recovery/engraftment/, https://www.lls.org/facts-and-statistics/facts-and-statistics-overview/facts-and-statistics, https://www.genome.gov/genetics-glossary/Fibroblast, https://bloodstemcell.hrsa.gov/about/faqs, https://www.bmtinfonet.org/transplant-article/graft-versus-host-disease-gvhd, https://www.thelancet.com/journals/lanhae/article/PIIS2352-3026(15)00028-9/fulltext, https://www.leukaemia.org.au/blood-cancer-information/the-blood-cancer-journey/in-active-treatment/blood-cancer-treatment-options/stem-cell-transplants/haploidentical-stem-cell-transplant/, https://www.cancer.org/cancer/testicular-cancer/treating/high-dose-chemo-stem-cell.html, https://bethematch.org/transplant-basics/matching-patients-with-donors/how-does-a-patients-ethnic-background-affect-matching, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5395684/, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6141428/, https://cllsociety.org/2016/09/what-is-bone-marrow/, https://www.cityofhope.org/hope-inside/minority-and-mixed-race-bone-marrow-donation, https://www.acpjournals.org/doi/10.7326/M19-2936, https://network.bethematchclinical.org/about-us/nmdp-standards/final-nmdp-22nd-edition-standards-effective-5-1-14/, https://ashpublications.org/blood/article/134/Supplement_1/2035/427903/One-and-Half-Million-Hematopoietic-Stem-Cell, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4500122/, https://www.immunology.org/public-information/bitesized-immunology/cells/b-cells, https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/stem-cell-transplant/transplant-side-effects.html, https://bethematch.org/transplant-basics/how-marrow-donation-works/steps-of-bone-marrow-or-pbsc-donation/, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5013969/, https://bloodstemcell.hrsa.gov/data/transplant-survival-report, https://www.ncbi.nlm.nih.gov/books/NBK279392/, https://www.mds-foundation.org/wp-content/uploads/2011/10/BoneMarrowBook.pdf. (Note: Pregnant people and newborn babies may naturally have immature granulocytes in their bloodstream. It may also develop as a side effect of cancer treatment. Bone marrow contains immature cells called stem cells. Adult stem cells. This allows older adults and those with other health problems to have a transplant. The development of a granulocyte may take 2 weeks, but this time reduces when there is an increased threat, such as a bacterial infection. Other lymphocytes begin life in red bone marrow and become fully formed in the lymphatic tissues, including the thymus, spleen, and lymph nodes. Bone marrow conditions are also a primary cause of granulocytosis. Another name for high levels of red blood cells is polycythemia. These are a type of lymphocyte that directly attack cells that a virus has infected. If a person is donating bone marrow instead of PBSC, there is no need for filgrastim injections. When you dont have enough granulocytes, your body is more vulnerable to infections. It prevents blood from clotting. The World Marrow Donor Association (WMDA) is a collective database of hematopoietic cell donor registries from 55 countries. Damaged kidneys cant produce as much EPO, leading to low levels. This problem has been solved! This also kills all healthy bone marrow that remains and allows new stem cells to grow in the bone marrow. most commonly found in flat bones. However, if your body doesnt make enough granulocytes or if your granulocyte count is too low or too high it could mean theres something more significant going on. It causes low EPO levels because your kidneys sense that you have enough red blood cells, so they dont produce as much EPO. I soon grew used to this new addition to my lunchtime routine. Make copies of your guide available for interested students. New red blood cell production, also called erythropoiesis, is triggered by low levels of oxygen in the blood. Bone marrow contains two types of stem cells: mesenchymal and hematopoietic. Inject myself twice. Preliminary searches through the NMDP also explore the WMDA. Red Bone Marrow. Frequently asked questions (FAQ). Cardiovascular health: Insomnia linked to greater risk of heart attack. A stem cell transplant usually takes place after chemotherapy and radiation therapy are complete. In humans the red bone marrow forms all of the blood cells with the exception of the lymphocytes, which are produced in the marrow and reach their mature form in the lymphoid . In ablative (myeloablative) treatment, a person receives high dose chemotherapy, radiation therapy, or both to kill any cancer cells. White blood cells called macrophages remove aging red cells in a process known as phagocytosis. This type of neutropenia is not present all of the time. A healthcare professional makes an incision about a quarter of an inch in length on both sides of the pelvic bone. If you get sick often, or are prone to infections, schedule an appointment with your healthcare provider. Theres also a synthetic (man-made) form of erythropoietin that healthcare providers use to treat anemia that results from chronic kidney disease. The guidelines aim to protect the health and safety of both the donor and the recipient. The overall 3-year survival rate is 8995% for transplants from related donors or 77% if the donor is unrelated. If you notice that something isnt quite right, call your healthcare provider right away. Tonsils are secondary lymphatic structures. (2018). The lymphocytes can then travel between each node through lymphatic channels that meet at large drainage ducts that empty into a blood vessel. Haploidentical stem cell transplant. Reticulocytes are immature red blood cells (RBCs). For example, for sickle cell anemia, the overall 1-year survival rate is 9497% if the donor is a relative or matched sibling or 83% if the donor is not related. B) originate as closed-ended tubes associated with blood capillary networks, A lymphatic capillary that picks up dietary lipids in the small intestine is called a(n), The force that drives fluid into lymphatic capillaries is, D) spaces between capillary endothelial cells that are arranged as one-way flaps, The path that fluid takes as it enters a lymphatic capillary is through, The lymphatic system's two main functions are to assist in, E) Capillaries - vessels - trunks - ducts. In most cases, periods of neutropenia last about three to five days. The spleen is essentially a giant lymph node, because it is encapsulated, has trabeculae, and filters lymph to remove antigens. They respond to various allergens that cause the release of histamines, heparin, and other substances. (n.d.). In some circumstances, B cells erroneously identify healthy cells as being antigens that require an immune system response. Red marrow contains blood stem cells that can become red blood cells, white blood cells, or platelets. Which is not correct regarding the white pulp of the spleen? ABO-mismatched bone marrow infusions can sometimes lead to hemolytic reactions. Echinacea Supplementation: Does it Really Improve Aerobic Fitness? National Institute of Diabetes and Digestive and Kidney Diseases. David N. Shier, Jackie L. Butler, Ricki Lewis, Human Anatomy and Physiology Laboratory Manual, Elaine N. Marieb, Lori A. Smith, Susan J. Mitchell, Essentials of Human Anatomy and Physiology. Red marrow fills the spaces in the spongy bone. There are two main types of bone marrow donation. It is possible to lower the risk of GVHD through careful tissue matching. As bone marrow affects many bodily systems, a problem can result in a wide range of conditions, including cancers that affect the blood. High or low levels of erythropoietin can cause health problems. This occurs during an infection, allergic reaction or asthma episode. Tonsils have multiple invaginated outer edges called _______ that help trap material. There are two major types of lymphocytes: B and T lymphocytes. There are three specific types of granulocytes. Thereafter, fat tissue gradually replaces the red marrow, which in adults is found only in the vertebrae, hips, breastbone, ribs, and skull and at the ends of the long bones of the arm and leg; other cancellous, or spongy, bones and the central cavities of the long bones are filled with yellow marrow. Some new cells remain as stem cells, while others go through a series of maturing stages, as precursor or blast cells, before becoming formed, or mature, blood cells. Cancellous bone typically contains red bone marrow, which is the site of blood cell production. In a study of 854 people who survived at least 2 years after autologous HSCT for hematologic malignancy, 68.8% were still alive 10 years after transplantation. Mature monocytes have a life expectancy in the blood of only 38 hours, but when they move into the tissues, they mature into larger cells called macrophages. It is composed of hematopoietic cells, marrow adipose tissue, and supportive stromal cells.In adult humans, bone marrow is primarily located in the ribs, vertebrae, sternum, and bones of .
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