Cytopenias and myelosuppression
The umbrella term for low blood counts of any kind (white cells, red cells, platelets) when treatment suppresses the bone marrow. Most chemotherapy causes it temporarily; radioligands, CAR-T and some pills cause longer-lasting versions.
Overview
Myelosuppression is the shared toxicity of cytotoxic chemotherapy, conditioning regimens, lymphodepletion, radioligand therapy (177Lu-PSMA, PRRT) and a range of targeted agents, graded per lineage by CTCAE; pancytopenia means all three lineages are low. Blood counts before each cycle gate treatment, and delays and dose reductions are the standard responses. After CAR-T, prolonged and biphasic cytopenias (ICAHT) affect a third of patients and drive infection deaths months after infusion; lymphopenia is a marker of poorer immunotherapy outcomes. Therapy-related MDS is the late, permanent form of marrow injury.
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