Yes it may, but there are other outcomes. Leukopenia does not necessarily result in leukemia. Sometimes, the leukopenia (low white-blood-cell count) is temporary, and the white blood cells recover without further problem. Sometimes, the leukopenia persists but transformation to leukemia does not occur.

Certain ethnic groups, particularly certain African subgroups, have persistent low white-blood-cell counts. However, these people have normal immune responses to infection. There is no link between this normal variant and leukemia.

The likelihood of a leukopenia turning into a leukemia depends upon what caused the leukopenia and if it is associated with a more complex medical disorder. Causes of leukopenia that can evolve into leukemia include toxins (such as benzene), immune system stimulation that results in cells and antibodies attacking young white cells, radiation, and chemotherapy. There are also several genetic problems (such as Fanconi's anemia), in which leukopenia is associated with other cellular deficiencies, often due to a deficiency in DNA repair mechanisms.

There are multiple disorders associated with leukopenia. Myelodysplastic syndrome is one of the more common reasons for a persistent leukopenia. In this condition, leukopenia is often present along with anemia (low red-blood-cell count) and thrombocytopenia (low platelet count). Less common are aplastic anemia and paroxysmal nocturnal hemoglobinuria, in which there is an autoimmune attack on the bone marrow that results in leukopenia.