II. Definition

  1. Bicytopenia: decrease in two of three cell lines
    1. May suggest Pancytopenia in development
  2. Pancytopenia: decrease in all blood cell lines
    1. Anemia
    2. Leukocytopenia
    3. Thrombocytopenia

III. Causes

IV. Signs: Clinical Clues

V. Labs

  1. Complete Blood Count
    1. Pancytopenia consistent with cell counts as below
  2. Peripheral Smear
    1. Macrocytic Anemia
    2. Reticulocytopenia (Reticulocyte Index <1%)
    3. Thrombocytopenia (Platelet Count <20,000/mm3)
    4. Neutropenia
      1. Absolute Neutrophil Count <500/mm3
      2. ANC <200/mm3 suggests very severe disease

VI. Evaluation

  1. Bone Marrow Biopsy: Normal count or hyperplasia
    1. Findings: Blasts, Dysplasia or Fibrosis
    2. Examples (See causes above)
      1. Myelodysplastic Syndrome
      2. Acute Myeloid Leukemia (AML)
      3. Agnogenic myeloid metaplasia
  2. Bone Marrow Biopsy: Fat infiltration (Hypoplasia)
    1. Acquired Aplastic Anemia or
    2. Fanconi's Anemia
      1. Diepoxybutane induced Chromosome breakage or
      2. Mitomycin-C induced Chromosome breakage

VII. References

  1. Lee (1999) Wintrobe's Hematology, Lippincott, p. 1449
  2. Saiki in Friedman (1991) Medical Diagnosis, p. 225

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