Pancytopenia

Pancytopenia means you have low levels of all three types of blood cells: red blood cells, white blood cells and platelets. If it helps, keep in mind that “pan” means all. “Cyto” means cell. And “penia” means a lack of something. Put together, pan-cyto-penia means you’re lacking all types of blood cells.

If your blood test result shows you have pancytopenia, it means you have all three of these conditions at the same time:

• Anemia: A low red blood cell count. You may not have enough red blood cells to carry oxygen throughout your body. This can make you feel exhausted and weak.
• Leukopenia: A low white blood cell count. Not having enough white blood cells can make it hard for your body to fight off germs.
• Thrombocytopenia: A low platelet count. Low platelets can make it harder for your blood to clot. As a result, you may bleed or bruise easily.

When all three blood cell counts are low, it means something is keeping your bone marrow from making enough healthy blood cells. Or you may have a condition that’s destroying the blood cells you do have. Either way, your healthcare provider will work to find out what’s causing your pancytopenia so that you get the treatment you need.

Symptoms of pancytopenia

Symptoms range from so mild that you don’t even notice them to so severe that you need emergency care.

Anemia symptoms

Symptoms of low red blood cells include:

• Extreme tiredness (most common)
• Dizziness
• Headache
• Pale skin or skin that’s lighter than normal
• Rapid or irregular heartbeat
• Shortness of breath

Leukopenia symptoms

Infections related to low white blood cell counts can cause symptoms like:

• Fever and chills (most common)
• Cough
• Diarrhea
• Mouth sores
• Sore throat
• Swollen lymph nodes

Thrombocytopenia

Signs of low platelets are:

• Bleeding and bruising easily (most common)
• Blood in your poop, pee or vomit
• Heavy periods
• Markings on your skin from bleeding just beneath, including red or purple dots resembling a rash

Pancytopenia causes

The most common causes of pancytopenia are cancer and noncancerous bone marrow disorders. They cause problems with how your bone marrow makes blood cells. But lots of conditions and even treatments can cause it. Causes include:

• Nutritional deficiencies: Your body may not have enough vitamin B12 and folate to make healthy blood cells.
• Autoimmune conditions: Your immune system may attack healthy blood cells, leaving you with low counts.
• Blood or bone marrow disorders: Conditions you develop in your lifetime or that you’re born with (rare) can cause your bone marrow to make abnormal blood cells.
• Cancer: Cancer cells can invade your bone marrow, keeping it from making enough healthy blood cells. Leukemia and myelodysplastic syndrome are common cancer diagnoses linked to pancytopenia.
• Exposure to toxins: Poisons in your environment, like benzene and arsenic, can damage your blood cells. Radiation exposure can cause pancytopenia, too.
• Infectious diseases: Germs (viruses, especially) can leave you with low blood cell counts.
• Liver disease: Alcohol-related liver disease can cause too many blood cells to get trapped in your spleen. When this happens, your spleen may swell and hurt.
• Treatments: Chemotherapy and radiation therapy to fight cancer can cause pancytopenia. Some medications can cause low blood cell counts.

How doctors diagnose this condition

A complete blood count (CBC) can show if you have pancytopenia. Values can vary based on things like your age, race and health. But in general, they’re as follows:

• Anemia: Hemoglobin less than 12 grams per deciliter (g/dL) in females and 13 g/dL in males
• Leukopenia: Fewer than 4,000 white blood cells per microliter of blood
• Thrombocytopenia: Fewer than 150,000 platelets per microliter of blood

Your healthcare provider will run more tests to find out what’s causing your low counts. You may need blood tests or a biopsy to check for cancer. You may need to see a hematologist — a healthcare provider who specializes in blood conditions — for diagnosis and treatment.

How is pancytopenia treated?

Treatment depends on what’s causing your low blood cell counts. In the meantime, you may need medicines or procedures to give your blood cells a boost. Treatments include:

• Medications: Certain medicines can spur your bone marrow to make more blood cells.
• Blood transfusion: You may need an infusion of red blood cells or platelets if your levels are dangerously low.
• Stem cell transplant: This procedure replaces unhealthy stem cells (the cells in your bone marrow that give rise to mature blood cells) with healthy ones.

You may need to take broad-spectrum antibiotics if your white blood cells are so low that you’re at risk of infections.

When should I see my healthcare provider?

See your provider if you have signs of low blood cells. Don’t hesitate to ask questions if you need help understanding what your blood test results mean for your health.

What can I expect if I have this condition?

Your outlook depends on what’s causing your low blood cell counts. Lots of things can cause pancytopenia. Since some causes (like cancer) are serious, your healthcare provider will act fast to diagnose the issue.

But it’s important not to assume you have a condition based on blood test results alone. You’ll need more tests before your healthcare provider can pinpoint the cause.

Is pancytopenia serious?

It can be. Sometimes, pancytopenia is a sign of a serious condition that requires long-term management. But it may also be a short-term finding that goes away once your healthcare provider cures or manages the disease causing it.

Your provider is your best resource for explaining what your test results mean for you.

What is the difference between thrombocytopenia and pancytopenia?

Pancytopenia means you have low levels of red blood cells, white blood cells and platelets. Thrombocytopenia means you have low levels of platelets only.

Is pancytopenia part of leukemia?

No. But pancytopenia is sometimes a sign of leukemia. With leukemia, the cancer cells in your blood can crowd out your healthy ones. This can lead to low blood cell counts.