12
Management
Table 4. Cytopenias Recommendations
Workup/Evaluation:
• CBC with differential, peripheral blood smear, reticulocyte count. If abnormalities
are detected and further investigation is necessary for a diagnosis, proceed with bone
marrow evaluation.
Grading Management
G1: anemia: LLN – 10.0 g/dL;
neutropenia: >1,500 per mm
3
;
thrombocytopenia: >75,000
per mm
3
• Offer supportive care.
G2: anemia: <10.0–8.0 g/dL;
neutropenia: >1,000 per mm
3
;
thrombocytopenia: >50,000
per mm
3
• Offer supportive care and/or consider
corticosteroids.
• If improved to ≤G1, taper steroids over 4–6
weeks.
G3: anemia: <8.0/dL;
neutropenia: >500 per mm
3
;
thrombocytopenia: >25,000
per mm
3
G4: anemia: life-threatening ;
neutropenia: <500 per mm3;
thrombocytopenia: <25,000
per mm
3
• Critical care support.
• Use high-dose methylprednisolone.
• Consider growth factor support for neutrophil
recovery, per institutional guidelines.
