Pancytopenia - Anaemias

Pancytopenia

Stem Cells

·        Blood stem cells detected by CD34+

·        Live in bone marrow: biochemical environment there necessary for survival – from fat, fibroblasts, endothelial & macrophage cells

Pancytopenia

·        Confirmed ¯RBC, ¯WBC and ¯platelets

·        Causes: 

o  ¯Production:

§  Bone marrow infiltration/failure

§  Megaloblastic anaemia

§  Miscellaneous (e.g. alcohol)

§  Aplastic/hypoplastic anaemia 

o  ­Margination: Hypersplenism

Aplastic Anaemia

·        Rare

·        Defect in supportive environment: dysfunctional stem cells, autoimmune damage

·        Criteria for severe:

o  Neutrophils < 0.5

o  Platelets < 20

o  Reticulocytes < 10 * 10E9

o  Hypocellular marrow

·        Causes:

o  Idiopathic

o  Drugs/chemicals

o  Radiation

o  Viral

o  Pregnancy

·        Treatment:

o  Supportive care

o  Immunosuppressive treatment

o  Stem cell transplantation