Etio-Morphological Spectrum of Bone Marrow in Pancytopenia

  • Indira Priyadarshini Anubrolu Department of pathology, Belagavi institute of medical sciences, Belagavi
  • Rashmi K Patil Belagavi institute of medical sciences, Belagavi
  • Shreekant K Kittur Belagavi Institute of Medical Sciences, Belagavi
Keywords: Pancytopenia, bone marrow examination, megaloblastic anemia


Background: Pancytopenia is a descriptive term referring to reduction in all three blood cell lineages: erythrocytes, leukocytes and platelets. A spectrum of primary and secondary disorders affecting the bone marrow may manifest with pancytopenia. The present study was carried out to know the morphological spectrum of bone marrow in pancytopenia patients and also to evaluate the causes of pancytopenia with the help of bone marrow examination.  Methods:  A prospective observational study was done for a period of 18 months that included 77 pancytopenia patients diagnosed based on haemoglobin concentration, total leukocyte count and platelet count. Detailed clinical history, haematological findings, radiological findings, serological and biochemical findings were taken as and when required for all the patients. Bone marrow aspiration and/or biopsy were done in all patients to assess the morphology of bone marrow and causes of pancytopenia. Results: The age distribution in 77 cases ranged from 18 months to 80 years. The most common affected age group was 31-45 years. The males were affected more commonly than females with M:F ratio of 1.7:1. The various causes of pancytopenia were megaloblastic anemia (64.9%), HIV associated dysplasia (15.6%), mixed nutritional deficiency anemia (5.2%), aplastic anemia (5.2%), acute myeloid leukemia (2.6%), idiopathic thrombocytopenic purpura (2.6%), myelofibrosis (1.3%) acute lymphoblastic leukemia (1.3%) and myelodysplastic syndrome (1.3%). The most common bone marrow finding was erythroid hyperplasia with megaloblastic maturation. Conclusion:  Pancytopenia should be suspected on clinical grounds in patients with decreased appetite, weakness, prolonged fever and tendency to bleed. Detailed primary haematological investigations coupled with bone marrow examination were vital in establishing diagnosis in pancytopenia patients. A large proportion of pancytopenia was attributable to megaloblastic anemia which was amenable to treatment. Hence, early and accurate diagnosis is lifesaving.

Author Biographies

Rashmi K Patil, Belagavi institute of medical sciences, Belagavi
Associate Professor, Department of Pathology Belagavi Institute of medical sciences, Belagavi
Shreekant K Kittur, Belagavi Institute of Medical Sciences, Belagavi
Professor & Head, Department of Pathology, Belagavi Institute of Medical Sciences, Belagavi


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Original Article