Clinico-hematological evaluation of pancytopenic adults in a tertiary care institution

Introduction: Pancytopenia is an important clinico-hematological entity encountered in our day-to-day clinical practice from a number of disease processes primarily and secondarily involving bone marrow. This study was carried out to evaluate bone marrow findings in patients with pancytopenia. Materials and Methods: This is a prospective cross sectional study carried out on 140 pancytopenia patients over the period of one and half years. Relevant clinical details were recorded, followed by screening of patients for routine blood investigations included a complete blood count, peripheral blood smear examination, reticulocyte count. Bone marrow aspiration was done in all cases and bone marrow biopsy performed whenever necessary and Perl's Prussian blue stain for grading of bone marrow iron stores were done in all cases. Data analysed was compared with various studies published in literature. Results: The maximum cases of pancytopenia were in the age group of 31 to 40 years with male preponderance. Dimorphic anemia (49.3%) was found to be the most common etiology of pancytopenia followed by megaloblastic anemia (35%), iron deficiency anemia (5.7%). We encountered two cases of non-Hodgkin's lymphoma and one case each of multiple myeloma, acute lymphoblastic leukemia, aplastic anemia and anemia of chronic disease. Most common clinical presentation was pallor followed by fatigue and fever. Conclusion: Present study concludes that basic primary hematological investigations along with bone marrow aspiration/trephine bone biopsy in the pancytopenia patients are helpful in understanding the disease process. This plays a key role in planning the further management.