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Indian Journal of Pathology and Oncology


Bone marrow examination findings in cases of pancytopenia- a study from central India


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Author Details: Sandeep Ojha, Amit Haritwal, Farah J. Meenai, Sonam Gupta

Volume : 3

Issue : 3

Online ISSN : 2394-6792

Print ISSN : 2394-6784

Article First Page : 479

Article End Page : 484


Abstract

Background and Objectives: Pancytopenia is one of the most common indications for bone marrow (BM) examination. There are spectrums of condition involving the bone marrow (BM) that can present with pancytopenia and include malignant as well as benign diseases. The objective of this study is to evaluate the BM findings in cases of pancytopenia.
Materials and Methods: This was a retrospective study of 156 cases of pancytopenia presenting over a period of 3 years. Data were retrieved from laboratory and clinical records and were analysed.
Results: Out of 156 cases, the most common cause for pancytopenia in this study was megaloblastic anemia (25.6%), followed by acute leukemia (16%), hypoplastic marrow (14%), metastatic solid tumors (8.9%), myelodysplastic syndrome (MDS) (7.1%), lymphomas (5.7%), plasma cell dyscrasia(3.8%). Along with these there were many benign yet rare causes which may present with pancytopenia like Hemophagocytic syndrome (1.2%), Histoplasmosis (0.6%), Leishmaniasis (0.6%) and Gaucher’s disease (0.6%). Bone marrow examination (combining both aspirate and biopsy) alone was sufficient in diagnosing 55% of cases, while remaining cases require additional details like clinical findings (for cases of MDS, viral infection, hypersplenism, autoimmune, septicemia) and special investigations like hemoglobin electrophoresis for hemoglobinopathy. In only 3.8% cases, BME was inconclusive.
Conclusion: BME is an important investigation in diagnostic work up of cases of pancytopenia. In majority of cases, it can provide an accurate diagnosis or at least can guide the approach towards diagnosis and management. Thus, it should be performed in all cases of persistent pancytopenia and should be evaluated in light of clinical details and supportive investigations.

Keywords:
Pancytopenia, Bone marrow aspiration biopsy, Causes, Clinical presentation