Assessment and Management of Pancytopenia - Flowchart
Assessment and Management of Pancytopenia - Flowchart Assessment and Management of Pancytopenia Assessment and Management of Pancytopenia
Flowchart

Pancytopenia on initial blood count

Pancytopenia on initial blood count

Pancytopenia on initial blood count

End

End

End

Haematologist's inspection of blood smear
Group & save or cross match
PT, APTT, Fibrinogen
Direct antiglobulin test
Reticulocyte count
Haematinics
Renal function
Liver enzymes
Acute and chronic viral serology
Autoimmune profile

Haematologist's inspection of blood smear
Group & save or cross match
PT, APTT, Fibrinogen
Direct antiglobulin test
Reticulocyte count
Haematinics
Renal function
Liver enzymes
Acute and chronic viral serology
Autoimmune profile

Haematologist's inspection of blood smear
Group & save or cross match
PT, APTT, Fibrinogen
Direct antiglobulin test
Reticulocyte count
Haematinics
Renal function
Liver enzymes
Acute and chronic viral serology
Autoimmune profile










Haemodynamic status
Fever
Overt or occult blood loss
Symptomatic anaemia
Evidence of potential cause (e.g. lymphadenopathy, splenomegaly)

Haemodynamic status
Fever
Overt or occult blood loss
Symptomatic anaemia
Evidence of potential cause (e.g. lymphadenopathy, splenomegaly)

Haemodynamic status
Fever
Overt or occult blood loss
Symptomatic anaemia
Evidence of potential cause (e.g. lymphadenopathy, splenomegaly)





Alert haematologist and arrange for urgent repeat FBC

Alert haematologist and arrange for urgent repeat FBC

Alert haematologist and arrange for urgent repeat FBC

Initial clinical assessment

Initial clinical assessment

Initial clinical assessment

Laboratory assessment

Laboratory assessment

Laboratory assessment

Re-evaluation review of blood film and initial investigations, and consideration of bone marrow examination

Re-evaluation review of blood film and initial investigations, and consideration of bone marrow examination

Re-evaluation review of blood film and initial investigations, and consideration of bone marrow examination

Fluid resuscitation as required; packed red cells if symptomatically anaemic

Fluid resuscitation as required; packed red cells if symptomatically anaemic

Fluid resuscitation as required

If platelet count < 50 × 109/L and haemorrhagic: give adult therapeutic dose of platelets

If platelet count < 50 × 109/L and haemorrhagic: give adult therapeutic dose of platelets

9 If platelet count

If absolute neutrophil count < 1 × 109/L and T >37.5°C: Blood cultures, broad spectrum antibiotics

If absolute neutrophil count < 1 × 109/L and T >37.5°C: Blood cultures, broad spectrum antibiotics

9 If absolute neutrophil count