cytopeni

Cytopenia, or cytopeni, is a reduction in the number of blood cells. It can involve a single lineage—such as anemia (low red blood cells), leukopenia or neutropenia (low white blood cells), and thrombocytopenia (low platelets)—or all three lineages, a condition called pancytopenia. The impact ranges from mild or asymptomatic to life-threatening, depending on which cells are affected and how severely.

Causes are diverse and include bone marrow disorders (such as aplastic anemia and myelodysplastic syndromes), marrow infiltration by cancer, autoimmune destruction, medications or chemotherapy, infections, nutritional deficiencies (iron, vitamin B12, folate), alcohol use, liver disease, and hypersplenism. In many cases, cytopenia results from a combination of factors or from an underlying systemic illness.

Symptoms reflect the affected cell line: fatigue and pallor from anemia; frequent or severe infections from neutropenia; and easy bruising, prolonged bleeding, or petechiae from thrombocytopenia. Diagnosis starts with a complete blood count showing low counts, followed by a peripheral blood smear and targeted laboratory tests to identify the cause. In some situations, a bone marrow examination is needed to assess marrow production and architecture.

Management focuses on treating the underlying cause and reducing symptoms. Mild cytopenias may require observation, while more severe cases may need transfusions, antibiotics for infections, or growth factors such as G-CSF or erythropoiesis-stimulating agents. Removal of offending drugs and supportive care are common strategies; in certain conditions, immunosuppressive therapy or hematopoietic stem cell transplantation may be indicated. Prognosis varies widely with the underlying disease and patient factors.