In your pediatric preceptorship, you meet a 7 year old boy who presents with fatigue and pallor. When you plot his growth on a chart, you find that he is short for his age, but he has always been this way. When you take a thorough history, you find that he has seen a doctor in the past for recurrent bacterial infections and an episode of hemorrhage. Both his parents are healthy and have no major medical conditions. However, the father said some of his relatives had been diagnosed with acute myelocytic leukemia. The mother said that some of her relatives had been diagnosed with squamous cell carcinoma of the head and neck. On exam, you notice several cafe au lait spots, "funny thumbs," and hypogonadism. Blood smear shows macrocytosis.
Challenge: What is your diagnosis?
1. A deficiency in which blood cell type would lead to fatigue and pallor?
2. A deficiency in which blood cell type would lead to recurrent bacterial infections?
3. A deficiency in which blood cell type would lead to hemorrhage?
4. What is the combination of the above three findings called?