A study of Bone marrow aspiration smears and Trephine biopsy in Pancytopenia cases.

Background: Pancytopenia is the simultaneous presence of anemia, leucopenia and thrombocytopenia. Peripheral pancytopenia may be a manifestation of a wide variety of disorders which primarily or secondarily affects the bone marrow. Bone marrow failure syndromes and malignancies are serious and life threatening causes, but certain non-malignant conditions such as infection, and nutritional anemia are equally important. The severity of pancytopenia and the underlying pathology determine the implementation of correct management and prognosis. Methods: A prospective study was conducted in the Upgraded Department of Pathology, Osmania government general hospital during July 2011 to September 2013that evaluated 110 patients fulfilling the criteria of pancytopenia. Detailed history, thorough clinical examination, complete hemogram, peripheral examination and reticulocyte count evaluation was performed in all the 110 patients. Bone marrow aspiration was performed in all 110 patients and in addition trephine biopsy was done in the same setting in patients where it is indicated. Result: The patients aged from 15 to 75 years,average age at presentation was 30.9yrs. The most common cause of pancytopenia was Megaloblastic anemia (53%) followed by Nutritional anemia (16%), aplastic anemia (9%) and Leukemia’s (7.4%). Majority (79%) of the patients had hyper cellular bone marrow followed by hypocellular (13%) and norm cellular marrow (8%). Conclusion: A detailed primary hematological investigations coupled with bone marrow examination viewed in light of the history and physical findings are vital in establishing the diagnosis in pancytopenia patients. Bone marrow Aspiration and Trephine biopsy are complementary to each other in cases requiring both the procedures.