Pancytopenia involves having low levels of red blood cells, white blood cells and platelets. You may experience symptoms associated with low levels of each type, including anemia (low red blood cells), increased risk of infection (low white blood cells) and excessive bruising or bleeding (low platelets).
Pancytopenia describes having low levels of all three blood cell types: red blood cells, white blood cells and platelets. Low levels of each type correspond with specific conditions.
If you have pancytopenia, you may have symptoms associated with some or all of these conditions, depending on how low your levels are.
Pancytopenia is likely common. It has multiple potential causes — so many that it’s hard to know exactly how many people have it during their lifetimes.
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Pancytopenia may be so mild that you may not notice symptoms until a provider discovers low levels during routine blood work. In other instances, pancytopenia is severe and potentially life-threatening without emergency care.
If you don’t have enough red blood cells, the organs and tissues throughout your body can’t get enough oxygen. Symptoms include:
Not having enough white blood cells can make you more susceptible to infections. These infections can cause symptoms that include:
A low level of platelets prevents your blood from clotting as it should. Symptoms include:
Pancytopenia usually involves a problem with blood cell production in your bone marrow. Your blood cells are made in your bone marrow during a process called hematopoiesis. Once they’re fully mature, they leave the marrow and circulate in your bloodstream.
Pancytopenia may result if your bone marrow doesn’t produce enough healthy blood cells or if these blood cells get destroyed.
Multiple conditions can interfere with blood cell production or lead to their destruction.
In rare cases, healthcare providers can’t determine what’s causing the low levels. This is called idiopathic pancytopenia.
Certain conditions cause bone marrow to produce abnormal blood cells. Most of these conditions are acquired (something you develop over time). Some are inherited (something you’re born with). Conditions include:
Cancer cells can invade your bone marrow, reducing the production of healthy blood cells. Cancers that can cause pancytopenia include:
Your body may not have enough nutrients, like Vitamin B12 and folate, to make healthy blood cells. Or, pancytopenia may relate to how much alcohol you drink. Excessive alcohol use is an important and common cause of pancytopenia.
Viruses can cause pancytopenia. Conditions include:
Your body’s immune cells can attack healthy blood cells. Autoimmune diseases that can cause pancytopenia include:
Some types of drugs, including several chemotherapy drugs, suppress blood cell production.
Poisons in your environment, including benzene and arsenic, can damage your blood cells. Low levels can also result from radiation exposure.
Some conditions may cause blood cells to get trapped in your spleen. Autoimmune conditions, cirrhosis of the liver and some cancers are all potential causes. When this happens, your spleen may enlarge (splenomegaly) and feel painful.
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Anyone with the above conditions may be at risk for pancytopenia. Still, you may be more likely to have it if you have a family history of blood disorders or if you’re receiving chemotherapy treatments that interfere with blood cell production.
A standard blood test called a complete blood count (CBC) can show if your levels are low. Values can vary depending on various factors, including your age, race and health.
Low levels are as follows:
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Once your healthcare provider determines that you have pancytopenia, they may perform various tests to determine what’s causing your low levels. You may need to see a hematologist — a healthcare provider who specializes in diagnosing, treating and managing blood conditions — for diagnosis and treatment.
Tests may include:
Depending on your test results, medical history and symptoms, your provider may also test for other potential causes, including:
Treatment involves curing or managing the underlying condition and reducing symptoms. You may also receive treatments that directly increase your blood cells. These include:
You may need to take broad-spectrum antibiotics if your neutrophils are extremely low, putting you at high risk of infection.
Your outlook depends on what’s causing your low levels. No data currently exist on the survival or success rates associated with pancytopenia treatments. Instead, researchers track outcomes according to treatment responses associated with the underlying condition.
As treatments for the underlying conditions improve, so do the outcomes associated with pancytopenia. It’s important to talk to your provider about your outlook. They can share the latest research findings and explain what they mean in relation to your situation.
It can be, depending on what’s causing your low levels. Your healthcare provider will work to determine the cause (and how serious it is) if you have pancytopenia.
Severe cases of pancytopenia can be life-threatening without treatment. Visit an ER (emergency room) immediately if you experience the following symptoms:
A note from Cleveland Clinic
Pancytopenia may affect you in various ways depending on how low your levels are and the underlying cause. Follow your healthcare provider’s guidance on how to care for yourself if your low levels put you at risk of developing anemia, infection or excessive bleeding. Ask about symptoms to look out for that warrant scheduling a visit with your provider.
Last reviewed on 06/22/2023.
Learn more about the Health Library and our editorial process.
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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy