I'm sorry to hear this. I don't know anything about pancytopenia, but I too am designated stage 4 and I have heart issues. In fall 2020, I had a viral infection. (Likely covid, although I never tested positive for it, but MDs agree the case records sound like it.) I went into total heart block and was admitted via the ER. After a week on ECMO, I crashed even more. Long story short, I spent 3 weeks on a ventilator, had two open-heart surgeries, developed congestive heart failure, and now have an ICD. I'm 71. I tell you this because I'm currently receiving chemo and have been since last April. Why is Kaiser declining to offer you chemo? Have you had a second opinion or a third opinion? If you really don't want to have chemo, I fully respect that. I see how that could be the logical choice. But if you want to consider treatment, I would fight tooth and nail to get to another clinic and get a new evaluation.

I know there are others on this board who are not currently in chemo and some who have decided to forgo any treatment except palliative care. I am hoping they will chime in with their experiences and share their knowledge. I wish you all the best.