Nonhemolytic Normocytic anemia
Pathologic features: pancytopenia characterized by severe anemia, neutropenia, and thrombocytopenia. Normal cell morphology, but hypocellular bone marrow with fatty
Causes: failure or destruction of myeloid stein cells due to:
1. Radiation and drugs (benzene, chloramphenicol, alkylating agents, antimetabolites)
2. Viral agents (parvovirus B19, EBV, HIV)
3. Fanconi's anemia (inherited defect in DNA repair)
4. Idiopathic (immune mediated. 1° stem cell defect); may follow acute hepatitis
Symptoms: fatigue, malaise, pallor, purpura, mucosal bleeding, pelechiae. infection.
Treatment: witlidrawal of offending agent, immunosuppressive regimens (antithymocyte
globulin, cyclosporine), allogeneic bone marrow transplantation, RBC and platelet
transfusion, G-CSF or GM-CSF.