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Medically reviewed by Last updated on May 2, 2022.

What is pancytopenia?

Pancytopenia is low levels of red blood cells, white blood cells, and platelets. Red blood cells carry oxygen to all the organs and tissues of your body. White blood cells help your body fight infection by attacking and killing germs. Platelets stop the bleeding when you are cut or injured. Pancytopenia increases your risk for infection and bleeding. Without treatment these problems can become life-threatening.

What causes pancytopenia?

There are many causes of pancytopenia. Any of the following may cause pancytopenia:

  • A genetic condition that causes low blood cell levels
  • An autoimmune condition that attacks the bone marrow
  • A viral or bacterial infection
  • Pregnancy
  • Not enough folic acid or vitamin B12 in the foods you eat
  • Cancer, chemotherapy, or radiation therapy
  • Exposure to toxins such as benzene, arsenic, or insecticides
  • Some medicines, such as antiseizure medicine, antibiotics, or medicines to treat autoimmune diseases

What are the signs and symptoms of pancytopenia?

  • Feeling tired, weak, dizzy, or short of breath
  • Frequent fevers or infections
  • Pale skin or purple or red dots on the skin
  • Bleeding from the gums or nose, blood in bowel movements or urine, or heavy bleeding from a cut
  • Heavy menstrual bleeding in females
  • Bruising easily, or getting bruises without an injury

How is pancytopenia diagnosed?

Your healthcare provider will examine you. Tell the provider about any symptoms you have. You may need any of the following:

  • Blood tests are used to check for infection and blood cell levels. Other blood tests are used to find the cause of pancytopenia.
  • A bone marrow biopsy is a procedure to remove a small amount of bone marrow from your bone. This procedure is used to check how well your bone marrow is making blood cells. The bone marrow sample is also checked for tumors or anything that prevents the bone marrow from making healthy cells.
    Bone Marrow Aspiration

How is pancytopenia treated?

The treatment of pancytopenia depends on the cause. You may need any of the following:

  • A blood transfusion can help increase red blood cell, white blood cell, and platelet levels. This may prevent bleeding or organ damage. This does not treat pancytopenia. Instead, a blood transfusion may keep you safe until the cause of pancytopenia is known.
  • A stem cell transplant is a procedure to replace unhealthy stem cells with healthy cells. Stem cells are able to become all of the blood cells. Stem cells can also travel to your bone marrow and can become new bone marrow cells.

How should I balance rest with activity?

Rest when needed. Rest will help you save energy for other activities. Do activities when your energy levels are the highest. Know your limits and do not plan too many activities for one day.

How do I prevent or control bleeding?

  • Do not take aspirin or NSAIDs. These medicines can cause you to bleed and bruise more easily.
  • Use caution with skin and mouth care. Use a soft washcloth and a soft toothbrush. This can keep your skin and gums from bleeding. Keep your nails trimmed to prevent scratches. If you shave, use an electric shaver.
  • Apply firm, steady pressure to stop bleeding from a wound. Apply pressure with a clean gauze or towel for 5 to 10 minutes. Call 911 if bleeding becomes heavy or does not stop.
  • Do not play contact sports or do activities that can cause bleeding. Ask your healthcare provider what activities are safe for you to do.

What can I do to prevent infections?

  • Wash your hands often. Use an alcohol-based hand rub if soap and water are not available.
  • Stay away from crowds and anyone who may be sick. Ask your healthcare provider if you need to wear a mask in public places.
  • Eat a low-bacteria diet as directed. This will help decrease your risk for an infection. Choose, prepare, and cook foods that contain a low amount of bacteria. Examples include pasteurized milk, well-cooked meats, and cooked pasta. Ask your healthcare provider for more information about a low-bacteria diet.

Call 911 of have someone else call for any of the following:

  • You cannot be woken.
  • You have a seizure.
  • You have trouble breathing.
  • You cannot stop the bleeding from a wound even after you hold firm pressure for 10 minutes.

When should I seek immediate care?

  • You have a fever or chills.
  • You feel dizzy or you faint.
  • You have blood in your bowel movements or urine.
  • Your heart is beating faster than usual.

When should I contact my healthcare provider?

  • You have a rash or red or purple dots on your skin.
  • You feel more tired than usual.
  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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