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This condition can be caused by certain medications and by infections. In some cases, it is caused by a cancer or precancerous condition. Myelofibrosis, bone marrow scarring that can result from various hematologic cancers, typically leads to low blood counts. Pancytopenia can also be caused by aplastic anemia, a bone marrow failure disorder that affects blood cell production.
1 The resulting fibrous scar tissue formation in the bone marrow leads to severe anemia, weakness, fatigue, an enlarged spleen and liver, and body wasting (loss of body mass or size).  Is a type of chronic leukemia and can occur on its own (primary myelofibrosis) or as a result of another bone marrow disorder. Other MPNs that can progress to myelofibrosis include polycythemia vera and essential thrombocythemia.