Bone Marrow Examination in Cases of Pancytopenia

Abstract

This study was carried to identify the causes of pancytopenia and to fi nd out the bone marrow
morphology in cases of pancytopenia.
It was a cross sectional study conducted over a period of two years in the Department of Pathology,
Tribhuvan University Teaching Hospital. Bone marrow aspiration smears of patients fulfi lling the
criteria of pancytopenia were examined. The data obtained were analyzed using measures of central
tendency.
One hundred and forty eight cases underwent bone marrow aspiration and it constituted 15.74% of
total cases. Mean age was 30 years (range, 1-79 years). 42 cases were children (28.37%). Male: female
ratio was 1.5:1. The commonest cause was hypoplastic bone marrow seen in 43 cases (29%) followed
by megaloblastic anemia in 35 cases (23.64%), and hematological malignancy in 32 cases (21.62%).
Erythroid hyperplasia was seen in 29 cases (19.6%) and normal bone marrow was seen in 5 cases
(3.38%). There was one case each of Niemann-Pick disease and metastatic neuroblastoma in children
and chronic pure red cell aplasia and leishmaniasis in adults. Acute leukemia was the commonest
hematological malignancy. In children, commonest fi nding was hypoplastic bone marrow (38.1%)
while in adults megaloblastic anemia (30.18%) was commonest fi nding followed by hypoplastic
anemia (25.47%).
In present study bone marrow examination was able to establish diagnosis in 77% of cases. Hypoplastic
marrow was the commonest diagnosis, followed by megaloblastic anemia, and hematological
malignancies.
Key Words: Bone marrow aspiration, hypoplastic anemia, leukemia, megaloblastic anemia,
pancytopenia