What is the cause and treatment for pancytopenia?
Q: I am suffering from pancytopenia for the past 8 years, which was accidentally found during the annual health test because of low platelet count at 50,000, ten years ago. I am 61 years old, slim built and in good health. I have undergone complete medical examination including the bone marrow, which showed that some megakaryocytes are produced. I have no problems except pancytopenia. I have not been on medications for the past 8 years, except that I take multivitamin tablets. I get minor bruises and sometimes, small blood clots inside the mouth, which disappear very soon. My last haemoglobin count was 11.8; WBC - 3.9; RBC - 4.0; Platelet - 45 K (improved from 42 - 2 years back). The doctor prescribed folic acid, Vitamin B12 & B complex tablets. Are there any new inventions or any other cure including Ayurveda for the same?
A:You do not have pancytopenia but thrombocytopenia (decreased platelets) as your haemoglobin and white cell count are within the biological reference intervals. Your symptoms of mucosal bleed are due to the low platelet count. Pancytopenia (bone marrow failure syndrome) may be due to inherited or acquired disorders that affect the hematopoietic stem cell. This may involve either one cell line or all of the cell lines -red cells (anaemia), white blood cells (leukopenia) or platelets (thrombocytopenia). The most common cause of acquired bone marrow failure is aplastic anaemia but it may also be secondary to myelodysplastic syndrome, paroxysmal nocturnal hemoglobinuria or some malignancies. The damage to the progenitor cell may be qualitative or quantitative and the cause could be a congenital defect resulting in inherited forms of the disease or due to exposure to a noxious substance like viruses, toxins, or chemicals. There may also be immune-mediated suppression of hematopoiesis (blood cell formation). The treatment is based on the underlying mechanism thought to be responsible for it. Hematopoietic growth factors and androgens have been tried in an effort to stimulate hematopoiesis and immunosuppressives are used if an immune mechanism is suspected. You should get a bone marrow examination done to assess cellularity & morphology of residual cells along with cytogenetic/molecular studies to document any chromosomal abnormality.