Diagnostic utility of bone marrow aspiration in pancytopenia

Back ground: Pancytopenia is a common haematological finding in clinical practice. It is a striking feature of many serious and life-threatening illnesses, ranging from simple drug-induced bone marrow hypoplasia, megaloblastic anaemia to fatal bone marrow aplasias and leukaemia. The severity of Pancytopenia and the underlying pathology determine the management and prognosis. Thus, identification of the correct cause will help in implementing appropriate therapy .Pancytopenia is a common haematological finding for which bone marrow aspiration is conducted. Aim: To study the bone marrow aspiration smears in Pancytopenia cases and correlating with peripheral smear and clinical findings to arrive at a diagnosis. Materials and methods: This was a study conducted at Department of Pathology, Gandhi Medical College on 148 cases of Pancytopenia presenting over a period of 2 years. Clinical findings, complete blood counts and peripheral smear findings were recorded and Bone marrow aspiration was done. Smears were stained with Leishman stain. Perls' stain was done in all cases. Special stains like MPO, PAS, Reticulin staining was done if needed. Results: Out of 148 cases of Pancytopenia 67 cases were males and 81 were females. Most of the cases were in the age group of 10-20 followed by 20-30. Megaloblastic Anaemia was found to be the most common cause of Pancytopenia followed by hypoplastic marrow. Conclusion: A thorough Evaluation of bone marrow smears can diagnose underlying pathology in most cases of Pancytopenia. Correlating bone marrow features with clinical and haematological findings aid in diagnosing and management of most cases of Pancytopenia.