Haematological Evaluation in Patients of Pancytopenia by Bone Marrow Aspiration

BACKGROUND Pancytopenia is a reduction in all three major series of formed elements of blood i.e. erythrocytes, leucocytes and platelets. Pancytopenia is not an uncommon condition encountered in day to day clinical practice. The underlying aetiology of pancytopenia determines the management and prognosis of patients. Bone marrow aspiration is a minimally invasive, out-patient procedure which provides definitive diagnosis in a case of pancytopenia. In developing countries like India, the causes of pancytopenia are not well defined, hence, we conducted this study in Bundelkhand region of India to evaluate causes of pancytopenia. We wanted to evaluate haematological findings in patients of pancytopenia, and to study bone marrow findings by bone marrow aspiration to understand the underlying aetiology of pancytopenia. METHODS This prospective study was conducted in the Department of Pathology at MLB Medical College, Jhansi, among 65 patients over a one and a half year period from March 2018 to September 2019, to evaluate the causes of pancytopenia. RESULTS We found that out of 65 cases, 32 cases were of megaloblastic anaemia (49.23 %), 20 cases were of dimorphic anaemia (30.77 %), 6 cases were of hypersplenism (9.23 %), 4 cases were of subleukemic leukemia (6.15 %), 2 cases of aplastic anaemia (3.7 %) and 1 case was of myelodysplastic syndrome (1.54 %). CONCLUSIONS Along with detailed clinical examination and complete blood count, bone marrow examination is indispensable to diagnose the aetiology of pancytopenia, thereby helping clinician in planning management of these patients. KEY WORDS Pancytopenia, Megaloblastic Anaemia, Dimorphic Anaemia, Bone Marrow Examination