To investigate the immunoregulatory effect of bone marrow IL-23R+CD4+ T helper 17 cells and the secretion of IL-6, IL-17, and IL-23 cytokines in patients with immune-related pancytopenia (IRP). We used samples from patients with IRP, hematopoietic failure diseases (HDDs), or with complete remission after IRP immunotherapy (IRP-CR). The bone marrow IL-23R+CD4+/CD4+ (Th17 cells) cell ratio was measured by flow cytometry (FCM). IL-6, IL-17, and IL-23 expression levels in the bone marrow supernatants were measured by enzymelinked immunosorbent assay (ELISA). Differences among the groups were assessed. The IL-23R+CD4+/CD4+ cell ratio and the levels of IL-6, IL-17, and IL-23 in the bone marrow supernatant of patients with IRP were significantly higher than those in the HDD, IRP-CR, and healthy groups. The IRP group was compared with the remaining three groups and differences with P <0.05 were considered significant. No significant differences were observed among the HDD, IRP-CR, and NC groups. Taken together, we firstly observed the role of Th17 cells in the occurrence and development of IRP, which provided a new target for the therapy of IRP. © 2021 by American Scientific Publishers.