What is Pancytopenia

Pancytopenia is a condition in which there is an abnormally low amount (deficiency) of the following blood cells:

• Red blood cells (RBCs). Having too few RBCs is called anemia.
• White blood cells (WBCs). Having too few WBCs is called leukopenia.
• Cells that help the blood clot (platelets). Having too few platelets is called thrombocytopenia.

Cells that become blood cells (stem cells) are made in the soft tissue inside the bones (bone marrow). All blood cells have a limited lifespan. Blood cells are constantly replaced with new blood cells from the bone marrow. Pancytopenia can be caused by any condition or disease that:

• Destroys the ability of bone marrow to make blood cells.
• Causes bone marrow to make blood cells that cannot survive after they leave the bone marrow.

What are the causes?

There are many possible causes of this condition. In some cases, the cause is not known. Common causes include:

• A disease that causes bone marrow to make immature blood cells (megaloblastic anemia).
• A blood disorder that makes bone marrow unable to produce enough new RBCs (aplastic anemia or bone marrow failure).
• An enlarged spleen (hypersplenism). An enlarged spleen can trap blood cells and destroy them faster than they can be replaced.
• Inherited diseases of the blood or bone marrow.
• Cancers that affect bone marrow.
• Certain medicines, such as:
  • Chemotherapy.
  • Medicines that reduce the activity of the immune system (immunosuppressant medicines).
• Exposure to radiation.
• Severe infections.

What increases the risk?

The following factors may make you more likely to develop this condition:

• Being 30‒50 years old.
• Being a man.
• Having a family history of a blood or bone marrow disease.
• Having certain conditions, such as:
  • Alcohol use disorder.
  • HIV (human immunodeficiency virus) or AIDS (acquired immunodeficiency syndrome).
  • Cancer.
  • Conditions in which the body’s disease-fighting system attacks normal tissues (autoimmune diseases).

What are the signs or symptoms?

Symptoms of this condition vary depending on the cause and may include:

• Anemia.
• Weakness.
• Shortness of breath.
• Unusual bruising and bleeding.
• Frequent infections.
• Fatigue.
• Fever.
• Pale skin.
• Bone pain.
• Night sweats.
• Weight loss.
• Headache.
• Dizziness.
• Feeling unusually cold.

How is this diagnosed?

This condition may be diagnosed based on:

• Your symptoms.
• Your medical history.
• A physical exam.
• Removal of a sample of bone marrow to be examined under a microscope (biopsy). This is done by inserting a needle into a bone to remove fluid and cells (aspiration).
• A complete blood count (CBC). This is a group of tests that measures characteristics of WBCs, RBCs, and platelets.
• A peripheral blood smear. This test examines your blood under a microscope to provide information about drugs and diseases that affect RBCs, WBCs, and platelets.
• Reticulocyte count. This is a test that measures the amount of new or immature RBCs (reticulocytes) that are made by your bone marrow.
• Imaging studies of your spleen or liver, such as X-rays.
• A test to measure your vitamin B12 level.
• Tests for viruses.

How is this treated?

Treatment for this condition depends on the cause. Treatment may include:

• Immunosuppressant medicines.
• Antibiotic medicine.
• Vitamin B12. This may be given as a treatment for megaloblastic anemia.
• Medicines that help the bone marrow make blood cells (bone marrow stimulating drugs).
• A bone marrow transplant.
• Receiving donated blood through an IV tube (blood transfusion).
• A procedure to remove your spleen (splenectomy). This may be done as a treatment for hypersplenism.

Follow these instructions at home:

Caring for Your Body

• Wash your hands often with soap and water. If soap and water are not available, use hand sanitizer.
• Brush your teeth twice a day, and floss at least once a day. It is recommended that you visit the dentist every six months.
• Stay up to date on your vaccinations, including a yearly (annual) flu shot. Ask your health care provider which vaccines you should get, such as a vaccine against pneumonia.

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you were prescribed an antibiotic medicine, take it as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.

General instructions

• Work with your health care provider to manage your condition and educate yourself about your condition.
• Do not participate in contact sports or dangerous activities. Ask your health care provider what activities are safe for you.
• Follow food safety recommendations as told by your health care provider.
• During cold and flu season, avoid crowded places and avoid contact with people who are sick. Flu season is typically between the months of October and May.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have a fever.
• You bruise or bleed easily.
• You are dizzy.
• You feel unusually weak or tired.

Get help right away if:

• You have bleeding that does not stop.
• You have wheezing or shortness of breath.
• You have chest pain.

These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.). Do not drive yourself to the hospital.