HAEMATOLOGICAL DISORDERS

Objectives: To analyse the pattern of hematological disorders through bonemarrow aspiration, and to compare the final diagnoses with their referral diagnoses made by thereferring physicians.Study Design: Cross sectional descriptive study. Period: 1st January -2016to 30th December-2016. Setting: Department of Pathology, Khyber Teaching Hospital, Peshawar.Materials and Methods: 352 patients were included in the study. Bone marrow diagnosiswas recorded. Data was analysed by SPSS version 18 and results were drawn accordingly.Results: A total of 352 patients underwent bone marrow aspiration during the study period.About 15 patients had diluted bone marrow aspirates. So, they were excluded from the study.The remaining 337 patients were included in the study. The age of the study sample rangedfrom 9 months to 72 years (mean age 36 years ±17.8 SD). There were 185 (55%) male and151 (45%) females. Male to female ratio was 1.2:1. The commonest indication for bone marrowaspiration was “suspected malignancy”, which was suspected in 114(33.85) patients, followedby “pancytopenia”, which was seen in 69(20.55%) patients. About 69 (20.5%) patients werereferred for work up of anemia. Bicytopenia was seen in 69(20.5%). The bone marrow aspirationshowed that megaloblastic anemia was the commonest disorder observed in 37(10%) cases.Second common disorder was acute lymphoblastic leukemia, that was seen in 31 (9%) patients,followed by acute myeloid leukemia, which was seen in 26(7.7%) cases. Hemolytic anemia wasseen in 20 (15.9%) cases. Aplastic anemia was seen in 18 (5.3%) cases. Multiple myeloma andmononuclear infiltration was seen in 17 (5%) patients each. Anemia of chronic disorder wasseen in 16(4.7%) cases. Idiopathic Thrombocytopenic Purpura was seen in 12 (3.6%) patients.Iron deficiencyanemia was seen in 11 (3.3%) patients. Chronic Lymphocytic Leukemia wasseen in 10 (2.9), Mixed deficiency anemia in 9 (2.7%), Myelodysplasia in 6 (1.7%), Malaria in5(1.5%), and Niemann Pick in 4 (1.2%) patients. Gaucher disease and Visceral Leishmania wasseen in 2 (0.6%) patients each. Histiocyticlymphohistiocytosis and Chediak Hegashi syndromewas seen in 1 (0.3%) patients each. Conclusions: Megaloblastic anemia, Acute LymphoblasticLeukemia, Acute Myeloid Leukemia, Hemolytic Anemia and Aplastic Anemia are the commonhematological disorders in our set up. Bone marrow is a reliable procedure to diagnosishematological diseases when routine investigations fail to make diagnosis.