Evaluation of bone marrow in patients with pancytopenia

Abstract

Background: Pancytopenia is a common hematological finding resulting from varieties of disease processes that require evaluation of bone marrow. This study was carried out to evaluate bone marrow findings in patients presenting with pancytopenia. Materials and Method:This was a prospective cross sectional study carried out to identify the causes of pancytopenia based on bone marrow examination. Bone marrow examinations were performed in 503 cases for different indications over a period of one year. Results:One hundred and two (20.27%) cases fulfilled the criteria of pancytopenia. Trephine biopsy was possible only in 48 cases. In 75% cases aspiration findings were similar to biopsy. Mean age of patients was 38.8 years. Maximum number of cases was seen in age group of 15-30 years. Hypoplastic anemia was the commonest cause followed by hematological malignancies, megaloblastic anemia, leishmaniasis and Gaucher disease. Bone marrow examination alone was able to establish the diagnosis in 76.5% cases. In rest marrow findings were nonspecific and in 4.9% cases findings were normal. Conclusion:Bone marrow aspiration coupled with trephine biopsy can diagnose majority but not all the cases of pancytopenia. Hypoplastic anemia, hematological malignancies and megaloblastic anemia are the commonest causes of pancytopenia. Maximum diagnostic yield can be achieved by correlation with clinical findings, peripheral blood findings and with other laboratory and radiological parameters.

A Relevance Study of Bone Marrow Aspiration and Bone Marrow Biopsy in Haematological and Non Haematological Disorders

“…It is necessary that findings of a dry tap should never be dismissed as benign due to faulty technique and always need a bone marrow biopsy. (2,17,25) In the present study, out of 150 cases, 28 (18.66%) cases were evaluated for pancytopenia, which was in close agreement with study by Jha et al (24) The frequency of bone marrow examination for evaluation of pancytopenia was 17.34% In our study patients of acute leukemia were 19 (12.67%) in which 3cases(15.78%) were ALL and all 3 patient were male. Patient of AML were 16(84.22%), male to female ratio was 4:1 and maximum patients were in third to fourth decade of life.…”

Evaluation of pancytopenia on bone marrow aspiration- study at a tertiary care center in Kashmir valley, India

“…In a study conducted by Mir et al acute leukaemia was the second commonest etiology present in 6.78% of total patients. 15 Acute leukemia constituted 8.8% of total cases of pancytopenia in a study conducted by Pathak et al 16 Acute leukemia constituted third most common cause of pancytopenia in the study of Savage et al and similar finding was seen in study of Varma et al 17,18 In the study of Aziz et al acute leukemia constituted almost 10% of cases of pancytopenia and was third most common cause of pancytopenia. 19 In a study by Kumar et al aplastic anaemia was the commonest cause of pancytopenia seen in (29%) of cases.…”

“…This is very low as compared to study by Pathak et al where they found 20% of BMA showed erythroid hyperplasia. 16 Khodke et al found Normoblastic erythroid hyperplasia with peripheral pancytopenia in 14% of cases. 7 Dasgupta et al, reported an incidence of 2.42% of myelodyspastic syndrome, while present study had 4.5% incidence of myelodysplatic syndrome.…”

Bone marrow examination in cases of pancytopenia

“…Marrow is hypocellular in primary production defect while in case of ineffective erythropoiesis, increased peripheral utilization or destruction of cell and bone marrow with malignant infiltration are associated with hypercellular and normocellular marrow. 2 The presenting symptoms are usually attributable to the anemia or the thrombocytopenia. Leucopenia is an uncommon cause of initial presentation of the patient, but can become the most serious threat to life during the subsequent course of the disorder.…”

“…Leucopenia is an uncommon cause of initial presentation of the patient, but can become the most serious threat to life during the subsequent course of the disorder. 2 The frequency of underlying pathology causing pancytopenia varies considerably depending upon various factors including geographic distribution. Marrow aspiration is assessed for cytology and trephine biopsy provides overall cellularity, detection of focal lesion and infiltration.…”