Pancytopaenia - anaemia, thrombocytopaenia, neutropaenia
Bicytopaenia - anaemia with luekopaenia or thrombocytopaenia
| Acquired
|
- Bone marrow infiltration/replacement
- Malignant
- Acute leukemias
- Chronic leukemias/myeloproliferative neoplasms (MPN)
- Myelodysplastic syndromes (MDS)
- Multiple myeloma
- Metastatic cancer
- Non-malignant
- Myelofibrosis
- Infectious (eg, fungal, tuberculous)
- Storage diseases
- Bone marrow failure
- Immune destruction/suppression
- Aplastic anemia/paroxysmal nocturnal hemoglobinuria
- Medications¶
- Cytotoxic drugs
- Idiosyncratic reactions to medications
- Large granular lymphocyte leukemia
- Autoimmune disorders (eg, systemic lupus erythematosus [SLE], rheumatoid arthritis [RA], sarcoidosis)
- Hemophagocytic lymphohistiocytosis (HLH)
- Nutritional
- Megaloblastic (vitamin B12, folate)
- Excessive alcohol
- Other (eg, copper deficiency, zinc toxicity)
- Malnutrition/anorexia nervosa with gelatinous degeneration
- Marrow suppression
- Viral infection (eg, HIV, hepatitis, Epstein-Barr virus [EBV])
- Ineffective hematopoiesis (eg, MDS, nutritional)
- Destruction/sequestration/redistribution
- Consumption
- Disseminated intravascular coagulation (eg, associated with sepsis, acute promyelocytic leukemia)
- Splenomegaly
- Portal hypertension/cirrhosis
- Infections (eg, EBV)
- Autoimmune disorders (eg, SLE, RA/Felty syndrome)
- Malignancies (eg, lymphomas, MPN)
- Myelofibrosis with myeloid metaplasia
- Storage diseases (eg, Gaucher)
|
| Congenital
|
- Wiskott Aldrich syndrome
- Fanconi anemia
- Dyskeratosis congenital/telomere biology disorders
- Shwachman-Diamond syndrome
- GATA2 deficiency
- Hemophagocytic lymphohistiocytosis (HLH)
|
- Red flags
- Severe pancytopaenia
- Blasts or immature myeloid/lymphoid forms - acute leukaemia
- Abnormal lymphocytes (hairy cells, large granular lymphocytes, prolymphocytes)
- Leukoerythroblastosis with or without teardrop cells
- Pancytopaenia with haemolysis or thrombosis
- Pancytopaenia or bicytopaenia in an older individual with normal B12, folate and copper
