BONE MARROW EXAMINATION IN PANCYTOPENIA: A STUDY OF SIX YEARS

INTRODUCTION: Pancytopenia is reduction in all the three hematopoietic cell lines as seen in the peripheral blood. As hematopoietic cells are produced in the marrow, its examination forms an important tool in assessing the etiology of pancytopenia. AIMS: The aim of this study was to identify the etiology of pancytopenia using bone marrow examination and to correlate it with iron stores in the marrow. MATERIAL AND METHODS: This retrospective study was carried out over a period of six years in the department of pathology at Kamineni Academy of Medical Sciences and Research Centre from August 2008 to July 2014. In this period, a total of 765 bone marrow examinations were done, out of which 172 (22%) fulfilled the criteria for pancytopenia. Clinical details, complete blood picture and bone marrow aspiration were done in all the cases. In some cases, trephine biopsy was also done. The biochemical investigations of serum B 12, folic acid and the serum iron profile were available in few cases. RESULTS: In the 172 cases studied, the most common etiology for pancytopenia on marrow examination was that of megaloblastic anemia (38.95 %), followed by erythroid hyperplasia (19.18 %) and dimorphic anemia (14.53 %). Trephine biopsies helped in the diagnosis of aplastic anemias. The iron stores were found to be increased in cases of megaloblastic anemias (61.19 %). There were seven patients on antituberculous treatment, four showed megaloblastic anemia and two had hypoplastic marrows. CONCLUSIONS: Megaloblastic anemia was the commonest cause of pancytopenia in our study. The iron stores are usually high in cases of megaloblastic anemia. Patients on antituberculous drugs should be monitored. The biochemical investigations and the marrow examination should always be performed prior to instituting the treatment.