Bone marrow examination of pancytopenic children

Objective: To assess the clinical profiles and determine the frequency of different aetiologies of pancytopenia based on bone marrow examination. Methods: This is a retrospective study conducted over a 15 month period and included 279 pancytopenic children of both sexes from 1 month to 16 years of age, who underwent bone marrow biopsy. Patients on cancer therapy or on immunosuppressive treatment and already diagnosed cases of aplastic anaemia were not included in the study. Clinical profiles and bone marrow morphology findings of the patients were reviewed. Results: Acute leukaemia was the commonest aetiology 32.2% followed by Aplastic anaemia 30.8%, Megaloblastic anaemia 13.2% and miscellaneous aetiologies. Clinical presentation being pallor (81%), fever (68%), petechial haemorrhages (51%) bleeding manifestations (21.5%) and other features included hepatomegaly (44.8%), splenomegaly (37.2%) and lymphadenopathy (22.5%). Conclusion: Attempts should be made to establish the aetiology of pancytopenia without delay. Easily treatable causes if identified early can have a positive impact on mortality and morbidity of pancytopenic children.