Is pancytopenia a life-threatening disease?
Haematologist,
WHO,
Geneva
Q: My mother aged 53 years is suffering from pancytopenia and pneumonia. Last month, we got her admitted to the hospital and she is still in ICU. The doctors say that she is still not out of danger. Are pancytopenia and pneumonia dreadful diseases and can they prove fatal?
A:The bone marrow, found in the inner part of bones, is the site where all types of blood cells are produced from an early cell called stem cell. These stem cells grow in an orderly fashion to produce red blood cells (erythrocytes), white blood cells (leukocytes), and platelets (thrombocytes). The red blood cells carry oxygen from the lungs to all tissues of the body and remove carbon dioxide, a metabolic waste product. A decrease in red blood cells (anaemia) causes weakness, shortness of breath, tiredness, etc. White blood cells help the body to fight against germs - viruses and bacteria. They are of several types and each of these has a special role to play in protecting the body against infection. Their lack (leukopenia) predisposes to infections. Platelets, fragments of a marrow cell called megakaryocyte, are responsible for clotting of blood and help stop bleeding. A decrease in platelets (thrombocytopenia) may lead to bleeding problems. Pancytopenia is a condition in which there is failure of blood production characterised by a deficiency in all the three types of cells in blood – anaemia, leucopenia and thrombocytopenia. The condition may be caused by a primary disorder of the bone marrow or conditions which temporarily affect marrow function. Infections, nutritional deficiency, drugs, auto-immune disorders, or diseases of the bone marrow like aplastic anemia or a variety of cancers or pre-cancerous conditions can lead to it. A complete blood count, reticulocyte count, peripheral blood film examination and a bone marrow examination (aspiration & biopsy) need to be done along with good history taking and a thorough physical examination. The treatment and prognosis depends entirely on the underlying condition leading to it and therapeutic modalities can include transfusions, treatment of infections, immunosuppressive therapy or even a bone marrow transplant.