citopenias

Cytopenia, and in plural cytopenias, refers to a reduction in one or more of the formed blood cell lines. The main lines are red blood cells (anemia), white blood cells (leukopenia or neutropenia), and platelets (thrombocytopenia). When all three lines are reduced, the condition is known as pancytopenia. Cytopenias are defined relative to normal laboratory reference ranges and can be acute or chronic.

Causes of cytopenias vary and may be inherited or acquired. Acquired causes commonly include bone marrow failure (such as aplastic anemia or myelodysplastic syndromes), marrow infiltration by malignancy, chemotherapy or radiation, autoimmune disorders, nutritional deficiencies (iron, vitamin B12, folate), and infections (including HIV, hepatitis, parvovirus B19). Many drugs can suppress marrow production. Laboratory artifacts or pseudocytopenias can occur with certain anticoagulants or sample handling; repeating tests may be needed to confirm a true cytopenia.

Symptoms depend on the affected cell lines. Anemia can cause fatigue, pallor, and shortness of breath; leukopenia increases infection risk; thrombocytopenia leads to easy bruising and abnormal bleeding. Diagnosis starts with a complete blood count and differential, followed by a peripheral blood smear and targeted tests (iron studies, B12 and folate, liver and renal function). When marrow disease is suspected, a bone marrow examination may be required.

Management targets the underlying cause and may include transfusion for symptomatic anemia or severe thrombocytopenia, antimicrobial therapy for infections, and selective use of growth factors (such as erythropoietin or G-CSF). Pancytopenia requires supportive care and infection precautions; prognosis depends on the cause and response to treatment.