Bone Marrow Findings in Cases of Thrombocytopenia

Abstract

Background: Thrombocytopenia is commonly encountered in a wide range of haematological and non-haematological disorders. Bone marrow examination plays a major role in diagnosis. Aims: The aim of our study was to analyse the etiology and to study megakaryocytic series in different cases of thrombocytopenia, irrespective of age or sex. Methods: This prospective bone marrow aspiration study was done in 100 cases of thrombocytopenia, which were diagnosed on peripheral blood film, to analyse the causes of thrombocytopenia. Megakaryocytes were examined in terms of their number and morphology. Bone marrow aspiration smears were stained with Leishman stain andexamined under light microscope. Results: Megaloblasticanemia was the most common cause with 33 (33%) cases followed by acute leukemia with 21 (21%) cases, immune thrombocytopenic purpura with 11 (11%) cases, aplastic anemia with 9 (9%) cases, dimorphic anemia and chronic lymphoproliferative disorders with 6 (6%) cases each, systemic causes with 5(5%) cases, myelodysplastic syndrome with 3 (3%) cases, chronic myeloproliferativeleukemia with 2 (2%) cases and 1 (1%) case each of plasmodium vivax + kalaazar,kalaazar, microfilaria and multiple myeloma. Maximum numbers of dysplastic megakaryocytes were seen in 100% cases of MDS and CML. Most common morphological change seen was micromegakaryocytes. Conclusion: Bone marrow examination is an important step to arrive at the probable diagnosis of wide varieties of haematological disorders in the cases of thrombocytopenia. Correlation with clinical, peripheral blood film findings and bone marrow findings provide valuable insight into the etiology of thrombocytopenia.