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What is Pancytopenia: Causes, Symptoms, Treatment

What is Pancytopenia?

Pancytopenia is a pathological condition in which an individual has deficiency of all types of blood cells whether it is red blood cells, white blood cells, or platelets. It is a condition wherein the body is not able to produce enough blood cells in the body because the bone marrow does not function normally. Since an individual with Pancytopenia had severe deficiency of blood cells then it is quite understood that the whole body function of that individual will get affected. This can include shortage of oxygen being distributed to various vital organs of the body like the kidneys, liver, heart. Also people with Pancytopenia have a compromised immune system and tend to fall sick very easily.

There are two types of Pancytopenia, one is idiopathic and the other is secondary. In idiopathic type of Pancytopenia, the cause of the condition is not known but is normally caused by the autoimmune factors. The secondary type of Pancytopenia may be as a result of environmental causes. Majority of the cases of Pancytopenia are idiopathic meaning that their exact cause is not known. Some cases of Pancytopenia have also been caused as a result of viral infections, in patients undergoing chemotherapy or radiation for some form of cancers, certain drug reactions, or prolonged exposure to certain toxins. Pancytopenia can occur gradually over time or may be of a sudden onset.

The presenting features of Pancytopenia may include easy bleeding, easy bruising, shortness of breath, extreme lethargy and weakness, struggling to complete their chores. An individual with Pancytopenia is at an increased risk of infection due to the immune compromised state as a result of decrease in white blood cells.

Pancytopenia can be treated by stimulating the bone marrow with the help of medications so that it starts producing more blood cells, blood transfusions, and bone marrow transplant. Stem cell replacement therapy has also been successful in treating Pancytopenia.

What is Pancytopenia?

You need to consult a physician immediately or go to the nearest emergency room if you are a pancytopenic and have symptoms like very high fever, have seizures or convulsions, have severe shortness of breath or loss of consciousness even for a brief moment.

What are the Causes of Pancytopenia?

There can be numerous factors which may lead to development of Pancytopenia in an individual. Genes play a role in development of Pancytopenia as it has been shown to be a hereditary disease condition. Certain drug reactions also tend to cause Pancytopenia. Prolonged exposure to chemicals like arsenic can also cause Pancytopenia.

Autoimmune conditions also play a role in development of Pancytopenia. In extremely rare cases, Pancytopenia has been linked to pregnancy as well. Some of the environmental causes of Pancytopenia are:

  • Medications of certain classes of antibiotics and immunosuppressants
  • Exposure to toxins like benzene
  • Chemotherapy
  • Radiation exposure
  • Viral infections.

What are the Risk Factors for Pancytopenia?

Some of the risk factors for Pancytopenia are:

  • Chemotherapy
  • Exposure to environmental toxins like benzene or arsenic
  • An individual with a family history of Pancytopenia
  • Individuals with a history of lupus or other autoimmune conditions
  • In rare cases pregnancy
  • Radiation exposure
  • Certain classes of drugs like immunosuppressant drugs.

What are the Symptoms of Pancytopenia?

Individuals with Pancytopenia show generalized symptoms of severe fatigue and weakness. They tend to struggle to do their daily household chores due to the fatigue and weakness. They tend to lie in bed most of the time. They also tend to have easy bleeding and bruising. They may also have bleeding of the gums, nose, or in some cases bleeding of the internal organs. This bleeding can sometimes be heavy. Some of the common symptoms of Pancytopenia are:

  • Bleeding gums
  • Severe Fatigue
  • Frequent infections
  • Nosebleeds
  • Pale skin
  • Tachycardia
  • Rash
  • Shortness of breath
  • Severe Weakness.

Some of the more serious symptoms of Pancytopenia that may require immediate medical attention are:

  • Alteration in mental status
  • Loss of consciousness even for a few seconds
  • Excessive bleeding without a known cause
  • Severe shortness of breath
  • High fever.

How is Pancytopenia Diagnosed?

Pancytopenia is normally diagnosed through a blood test as it will clearly show a deficiency in the blood cell count than normal. If Pancytopenia is suspected then a bone marrow can also be done to rule out other medical conditions like leukemia, anemia or thrombocytopenia.

What is the Treatment for Pancytopenia?

For mild cases of pancytopenia, there is no treatment required and the condition may resolve on its own. Blood transfusions are done to bring the blood counts back to normal. This may need to be done on a frequent basis but it has been seen that blood transfusions become less and less effective with time. In severe cases of Pancytopenia, bone marrow transplant or stem, cell therapy can be done to restore the blood counts back to normal. These treatments are much effective in the younger population than the older population who may also require immunosuppressant drugs or bone marrow stimulating drugs additionally.

Pancytopenia caused due to environmental reasons or due to exposure to toxins resolves once the toxin is removed from their system and no treatment is required and the condition resolves on its own.

Immunosuppressant medications are also one of the methods to treat Pancytopenia. Some examples of these medications are:

  • Thymoglobulin
  • Corticosteroids
  • Cytoxan
  • Neoral.

Some of the medications used for stimulating the bone marrow are:

  • Procrit
  • Neupogen
  • Leukine.

What are the Potential Complications of Pancytopenia?

If Pancytopenia is left untreated, then it may lead to potential life threatening complications including severe bleeding and infections. These complications are more severe in the elderly population and they need extra care when it comes to treating Pancytopenia.

What is the Survival Rate for Pancytopenia?

Since Pancytopenia can be caused due to many factors, there is no consistent data regarding the survival rate for Pancytopenia. If the patient has leukemia causing low blood cell count then the prognosis of the patient will be linked to the status of leukemia as to whether or not the patient can be treated for Pancytopenia.


  1. Bain BJ. Pancytopenia. BMJ. 2016;352:i1283. doi: 10.1136/bmj.i1283. (https://www.ncbi.nlm.nih.gov/pubmed/26933106)
  2. Palmieri T, Lavrentieva A, Yannopoulos D, et al. Isolated Bone Marrow Lymphocytosis in Pancytopenia. Am J Case Rep. 2017;18:73-76. doi: 10.12659/AJCR.901356. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5253150/)
  3. Kedar A, Brown K, Sharathkumar A. Approach to Pancytopenia: Diagnostic Algorithm for Clinical Hematologists. J Blood Med. 2020;11:421-435. doi: 10.2147/JBM.S268698. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7361808/)
  4. Moyo VM, Gangaidzo IT, Gordeuk VR, et al. The pathogenesis and management of severe anemia in African children with Plasmodium falciparum malaria. Blood. 2003;102(11):3824-3831. doi: 10.1182/blood-2003-04-1049. (https://www.ncbi.nlm.nih.gov/pubmed/12933592)
  5. Spivak JL. Diagnosis and management of aplastic anemia. Hematology Am Soc Hematol Educ Program. 2006;1:128-136. doi: 10.1182/asheducation-2006.1.128. (https://www.ncbi.nlm.nih.gov/pubmed/17124057)
Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:July 25, 2023

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