Evaluation and Management of Chronic Pancytopenia

Pancytopenia is characterized by a decreased number of at least two blood cell lines. Pancytopeniamay progress acutely, such as with decreased blood cell counts in fulminant sepsis, disseminated intravascular coagulation, or rapid hemolysis. Alternatively, pancytopenia may evolve insidiously over weeks to months. In this review we focus on the latter group of acquired and congenital pancytopenias in children. Chronic pancytopenia is a diagnostic challenge. The range of potential causes is bewildering, signs and symptoms overlap substantially, and many diseases presenting with pancytopenia are life-threatening if not recognized and managed AUTHOR DISCLOSURE Dr. Sharma has disclosed no financial relationships relevant to this article. Dr. Nalepa has disclosed that research in his laboratory is supported through NIH Indiana Pediatric Scientist Award, a research grant from the Heroes Foundation, and Barth Syndrome Fund via Riley Children’s Foundation. This commentary does contain a discussion of an unapproved/investigative use of a commercial product/device.