Pancytopenia

What is pancytopenia?

Causes of pancytopenia

Pancytopenia has many possible causes. These include:

• Diseases such as cancer or bone marrow disorders
• Infections
• Medicine side effects
• Chemotherapy or radiation treatments
• Autoimmune disorders such as lupus
• Family history of blood disorders
• Environmental toxins, including radiation, benzene, or arsenic

In about half of pancytopenia cases, the cause is not known (idiopathic).

Symptoms of pancytopenia

A person with pancytopenia can have a broad range of symptoms which can vary in frequency and severity. Symptoms may come on gradually or all at once.

Signs and symptoms of pancytopenia include:

• Weakness
• Fatigue
• Skin problems, such as rashes or easy bruising
• Pale skin
• Rapid heart rate
• Shortness of breath
• Bleeding problems, such as bleeding gums, nosebleeds, or internal bleeding
• Infections

These symptoms are more serious and require urgent medical care:

• A fever higher than 101°F (38.3°C) by mouth or 100°F (37.8°C) under the arm
• Seizures
• Convulsions
• Heavy bleeding
• Severe shortness of breath
• Confusion
• Loss of consciousness (passed out)

Diagnosis of pancytopenia

Pancytopenia is diagnosed based on your child’s medical history, physical exam, and lab tests. Your doctor may ask you about any changes in bleeding or bruising, recent illnesses, or medicines your child is taking.

Lab tests for pancytopenia may include:

• Complete blood count (CBC) to measure the number and size of the blood cells
• Bone marrow aspiration and biopsy to look at the number and size of cells found in a bone marrow sample
• Genetic testing to check for inherited disorders or gene changes

Treatments for pancytopenia

Treatment for pancytopenia involves managing the complications of anemia, leukopenia, and thrombocytopenia as well as treating the underlying cause.

Identifying the root cause of pancytopenia is important for planning the right treatment. For example, if pancytopenia is caused by exposure to toxins, removing the toxins from the person’s environment may solve the problem.

Treatments for pancytopenia include:

• Medicines that stimulate the bone marrow to produce cells
• Medicines that suppress the immune system (if the immune system is thought to be attacking the bone marrow)
• A stem cell (bone marrow) transplant, which puts new stem cells into your child's body so they can create new blood cells
• Blood transfusions, such as getting red blood cells or platelets
• Watchful monitoring (for mild cases)

Prognosis for pancytopenia

The prognosis for pancytopenia varies widely depending on the severity of the condition and the underlying cause. Patients with pancytopenia can have serious complications, such as severe infections, bleeding, or heart problems.

Some patients may be cured with proper treatment. Other patients may need ongoing care and monitoring.

Living with pancytopenia

Children with pancytopenia may have frequent visits to the doctor and need hospital stays for health problems that occur.

Tips to help manage pancytopenia include:

Take steps to prevent infection: Wash hands often, keep patient areas clean, and stay away from people who are sick.

Don’t give your child any medicine without talking to your doctor: Some medicines can keep platelets from working properly and can increase the risk of bleeding. Talk to your care team before giving your child any medicine or supplement.

Alert others of your child’s condition: Be sure that others know about your child’s medical condition and know what to do if an accident or injury occurs. Tell all health care providers about your child’s diagnosis and any medicines they take. This is especially important before any medical or dental procedures.

Know what activities to avoid: If your child has fewer red blood cells, they may get tired more easily or get out of breath. Be sure your child does not overdo physical activity. When platelet counts are low, your child is at higher risk of bleeding. Your child should avoid contact sports, rough play, and activities that could involve falls or injury to the head or stomach.

Call your doctor or go to an emergency room right away if your child has any serious injury, especially one that involves any hit to the head or stomach.

When to call your care team

Call your health care provider if your child:

• Looks pale, has trouble breathing, or is more tired than usual
• Has skin or eyes that look yellow
• Has a fever at or above 101°F (38.3°C) by mouth or 100°F (37.8°C)
• Has other symptoms of illness or infection
• Bleeds easily or for too long after an injury

Questions to ask your care team

• What is the underlying cause of my child's pancytopenia?
• What treatment options are available?
• What lab test values do I need to know and what lab results do I need to watch closely?
• How will my child's condition affect their daily life, such as school attendance, sports, and other activities?
• What signs or symptoms should we watch out for that may indicate a worsening of my child's condition?
• Are there any clinical trials or research studies investigating new treatments for pediatric pancytopenia that my child may be eligible to participate in?
• What follow-up appointments and monitoring will my child need?
• What should I do in an emergency?

Related content