Confirming the pattern
Pancytopenia is confirmed with a repeat full blood count and a blood film. The film can show abnormal cells, blasts, fragments or nutritional changes that point to the cause.
The review looks for symptoms of anaemia, infection, bleeding, weight loss, fever, liver or spleen enlargement, and exposure to drugs, toxins or chemotherapy.
Related: Haematology → · Dr. Sachita Baniya profile → · All conditions →
Causes a haematologist assesses
Causes include marrow production failure (aplastic anaemia, MDS, leukemia, marrow infiltration), nutritional deficiency (B12, folate, copper), medicines and toxins, viral infections, autoimmune disease, hypersplenism and sepsis.
Bone marrow aspiration and biopsy, cytogenetics, flow cytometry and molecular testing are often needed. The results distinguish a benign reversible cause from a clonal or malignant disorder.
- B12, folate, iron and reticulocyte count
- Liver, renal and infection screening
- Marrow biopsy with cytogenetics and flow cytometry
- Medication and toxin review
Urgent care and treatment
Fever, severe bleeding, breathlessness or rapidly worsening counts need urgent assessment. Treatment depends on the cause and may include vitamin replacement, stopping an offending drug, transfusion, immunosuppressive therapy or treatment of the underlying malignancy.
Long-term follow-up monitors count recovery, transfusion need, infection and progression. The plan is explained in plain language, including which symptoms should prompt an emergency visit.
Access and booking
Dr. Baniya consults at Kathmandu Neurology Clinic & Cognitive Center, Durbar Marg, and also practises at Kathmandu Cancer Center (KCC) Nepal, Civil Service Hospital, Kathmandu, and Advanced Care Hospital. Appointments are arranged at the Durbar Marg clinic or through the respective hospital or cancer centre. Bring all blood counts, marrow, flow cytometry and molecular reports.