Overview
Pancytopenia describes a significant reduction in the number of nearly all blood cells. It is the combination of leukopenia, anaemia, and thrombocytopenia.
Pancytopenia can be caused by decreased bone marrow cell production, bone marrow failure, or increased destruction or sequestration.
Causes
Decreased bone marrow cell production
- Chemotherapy and radiotherapy
- Bone marrow infiltration, usually due to malignancy (lymphoma, leukaemia, myeloma)
- Non-haematological malignancies can cause bone marrow infiltration as well
- Severe megaloblastic anaemia
- Transfusion-associated graft-versus-host disease
- HIV
- Parvovirus B19 infections in patients susceptible to haemolytic anaemias, particularly sickle-cell disease and hereditary spherocytosis
- Myelodysplastic syndrome
Bone marrow failure
- Fanconi’s anaemia – autosomal recessive disorder characterised by decreased haematopoiesis and bone marrow failure
- Many other congenital causes
Increased destruction/sequestration
In general, causes of splenomegaly can lead to increased sequestration:
- Liver disease e.g. cirrhosis, chronic hepatitis B and C, autoimmune hepatitis
- Myeloproliferative disorders
- Chronic infection
Destructive causes may be:
- Drug-induced e.g. sulfonamides, quinine, and rifampicin
- Connective tissue disorders e.g. rheumatoid arthritis and systemic lupus erythematosus
- Cytomegalovirus infection
- Tuberculosis
- Infectious mononucleosis
- HIV
- Felty syndrome
