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Bone Marrow Biopsy Evaluation in Cases of Pancytopenia-An Institutional Experience

Pranati Mohanty, Ratiranjan Swain, Sandhya Rani Sahoo, Sudha Sethy

Background: Pancytopenia is not a disease entity, but a triad of findings, resulting from various disease processes. It is characterized by anaemia, leucopenia and thrombocytopenia in the peripheral blood. Bone marrow examination is of utmost importance in evaluation of pancytopenia and thereby identification of disease process is helpful for appropriate management. Aims and Objectives: To analyse wide spectrum of haematological diseases giving rise to pancytopenia in bone marrow trephine biopsy. Materials and Methods: This was a prospective study conducted in the department of Pathology and Clinical Hematology, S.C.B. Medical College, Cuttack for a period of 2 years including 122 pancytopenia patients. Complete blood count including peripheral smear examination, followed by bone marrow aspiration (BMA) and trephine biopsy were carried out in all cases. Informations were compiled and analysed. Results: Among 122 patients studied, 63.1% were males and 36.9% females. Aplastic anaemia was the commonest cause of pancytopenia (51%) followed by megaloblastic anaemia (23%). Other causes include acute leukaemia 9%, MDS 6%, primary myelofibrosis 2%, lymphomatous infiltration in the marrow 2%, and multiple myeloma 3%. Metastatic deposit, tuberculosis, haemophagocytic syndrome and hypersplenism constituted 1% each. Conclusion: BMA and biopsy were diagnostic in all the cases of pancytopenia. Though in few cases BMA yields a dry tap & inconclusive coupled with bone marrow biopsy (BMB) it helps in defining diagnostic and therapeutic strategies in pancytopenia.