Pancytopenia

What is pancytopenia?

The body contains three types of blood cells: red blood cells, white blood cells and platelets. Anemia occurs when there are too few red blood cells in the blood. Leucopenia is a condition with too few white blood cells. Low platelet count is called thrombocytopenia.

Pancytopenia occurs when a person has a decrease in all three blood cell types. This happens when something is wrong with the bone marrow, where blood cells are formed.

Pancytopenia has many possible causes:

• Diseases such as cancer, lupus or bone marrow disorders
• Infections
• Medicine side effects
• Environmental toxins, including radiation, benzene or arsenic
• Chemotherapy or radiation treatments
• Autoimmune disorders
• Family history of blood disorders

In about half of pancytopenia cases, the cause is not known (idiopathic).

Pancytopenia is serious and should not be ignored. Without treatment, it can lead to life-threatening symptoms that affect the entire body such as oxygen shortage and immune system problems.

How common is pancytopenia?

Because of its ties to a wide range of illnesses, pancytopenia is a somewhat common blood cell problem. The wide variety of causes makes it hard to find out exactly how often it occurs or which people are more likely to develop it.

What are the signs and symptoms of pancytopenia?

A person with pancytopenia can have a broad range of symptoms. The list of symptoms is long, and each can vary in frequency and severity:

• Weakness
• Fatigue
• Skin problems, such as rashes or easy bruising
• Pale skin
• Rapid heart rate
• Shortness of breath
• Bleeding problems, such as bleeding gums, nosebleeds or internal bleeding
• Infections

These symptoms are more serious and require urgent medical care:

• A fever higher than 101 degrees
• Seizures
• Convulsions
• Heavy bleeding
• Severe shortness of breath
• Confusion
• Loss of consciousness (passed out)

Any of these symptoms of pancytopenia may come on gradually or all at once.

How is pancytopenia treated?

Treatment for pancytopenia often involves treating both the bone marrow problems and the underlying cause. Correctly diagnosing the root cause of pancytopenia is important for applying the right treatment.

For example, if pancytopenia is caused by exposure to toxins, removing the toxins from the person’s environment may solve the problem.

For pancytopenia itself, treatments include the following:

• Drugs that suppress the immune system (if the immune system is thought to be attacking the bone marrow)
• Drugs that stimulate bone marrow
• Bone marrow transplant
• Blood transfusions
• Stem cell transplant
• Watchful monitoring (for mild cases)

What are the survival rates for pancytopenia?

Because of its many causes, there is no consistent data on the survival rates for pancytopenia.

For example, if a low blood cell count is caused by a serious disease such as leukemia, the prognosis for pancytopenia may be tied to that cancer.

Why choose St. Jude for your child’s pancytopenia treatment?

• St. Jude is the only National Cancer Institute-designated Comprehensive Cancer Center devoted solely to children.
• The nurse-to-patient ratio at St. Jude is unmatched — averaging 1:3 in hematology and oncology, and 1:1 in the Intensive Care Unit.
• In a recent study, the event-free survival rate was 100% in children who received a transplant at St. Jude.
• St. Jude is preparing for a study for patients without a matched donor and in whom drug therapy was only partially successful. Researchers are planning to use a therapy that changes the immune system in a different way than drug therapy. This therapy is expected to interrupt the disease process and allow the bone marrow to recover and produce blood cells again.
• St. Jude is also developing a new stem cell/bone marrow transplant regimen. It is for patients who do not have a matched sibling donor and who do not respond to the drug therapy. 
• St. Jude has one of the world’s largest stem cell transplant programs dedicated to caring for children, teens and young adults. Since the first stem cell transplant was performed at St. Jude in 1982, the Transplant Program has performed more than 2,900 transplants.
• St. Jude is accredited by the Foundation for the Accreditation of Cellular Therapy (FACT) for autologous and allogeneic peripheral blood and marrow transplantation in children and adults.
• The St. Jude Transplant Program has been a part of the National Marrow Donor Program (NMDP) since 1990. Our center also provides data to the International Bone Marrow Transplant Registry and Autologous Bone Marrow Transplant Registry.
• To improve outcomes and reduce side effects related to transplant, doctors in the St. Jude Transplant Program work closely with laboratory scientists to rapidly move discoveries from the lab to the clinic.
• St. Jude support staff have been specially trained to care for children receiving stem cell transplants.