Pancytopenia resident survival guide

Quick-take

Urgent hematology consult. Send out labs as detailed below. Plan for pt to get bone marrow biopsy.

Visual summary

Differential

Hypercellular bone marrow (1/Y):

Common: MDS (3-4/100K).

Rare: PNH, aleukemic leukemia, severe megaloblastic anemia

Hypocellular bone marrow (1/X):

Aplastic anemia (BM stem cell failure): idiopathic (most common), viruses (ParvoB19, HIV, EBV, HHV6), meds (chloramphenicol, NSAIDs, sulfa), other infection (anaplasma)

Workup

Bone marrow biopsy required for definitive diagnosis.

Treatment

Once identified, treat underlying cause.

Aplastic anemia: