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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.
Causes of High and Low RBC Counts. 1  Multiple myelomas, a type of cancer affecting plasma cells. 2  Erythropoietin deficiency, a kidney hormone that promotes RBC growth. 3  Deficiencies in iron, folate, vitamin B12, or vitamin B6. 4  Hemolysis, the abnormal breakdown of red blood cells. 5  Pregnancy.