Hi, I M Dr.Kumarbhargav Pathologist I understood your problem Looking to your profile If I would have been your treating clinician First i would like to have your CBC with peripheral smear examined first, Which would guide for further investigation, If as you provided it is pancytopenia means your blood cells decreased markedly and all the other causes as infections ruled out, Bone marrow aspiration and biopsy is the key to further guide. So proceed with bone marrow and provide findings, which is key in your case. Of course consider infection, drug history or any significant history. Thanks for contacting health care magic Take care, feel free to ask any more details.