DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20150830

Evaluation of bone marrow aspirate in paediatric patients with pancytopenia: a 2 years study

Mirza Asif Baig

Abstract


Background: Pancytopenia is an important clinico-hematological entity, characterized by a triad of Anemia, leucopenia and thrombocytopenia. It’s not a disease entity itself but a manifestation of many serious and life-threatening diseases. The criteria for defining Pancytopenia is Hemoglobin (HGB) <9 g/dL; total leukocyte count (TLC) <4,000 / µL or absolute neutrophil count (ANC) is < 1.5x 109/ L; platelet count, <100 x 109/ L. The main objective of this study is to classify pancytopenic cases on etiological basis.

Methods: A total of 750 bone marrow smears of pancytopenic patients were studied.

Results: It comprised of 72 % boys & 28 % girls with the highest number of cases < 5 years of age (64%).The maximum number of cases were of ALL and Aplastic anemias.

Conclusions: CBC, clinical findings and PBS provides valuable information in the workup of pancytopenic patients and help in planning additional investigations on bone marrow samples. Bone marrow evaluation is a valuable diagnostic procedure which may confirm the diagnosis of suspected cytopenias. So the take home message is a) pediatric leukemias unlike adults, usually presents with pancytopenia b) CBC+ PBS + BMA with flow cytometry can help in diagnosing majority of pancytopenias.


Keywords


Aplastic anemia, Megaloblastic anemia, Pancytopenia, Anemia, Leukemia

Full Text:

PDF

References


Dokal IS, Hoffman R. Chapter 12: Inherited aplastic anaemia/bone marrow failure syndromes in Postgraduate Haematology by Victor Hoffbrand, Daneal Catovsky. 2007;6:186-205.

Judith CWM, Young NS. Chapter 13: Acquired aplastic anaemia in Postgraduate Haematology by Victor Hoffbrand, Daneal Catovsky. 2007;6:206-225.

Kumar R, Kalra SP, Kumar H, Anand AC, Madan M. Pancytopenia- a six year study. J Assoc Physicians India. 2001;49:1079-81.

Agarwal R, Bharat V. Clinical and haematological profile of pancytopenia. International Journal of Clinical Biochemistry and Research. 2015;2(1):48-53.

Freedman MH, Hoffman R. Chapter 24: Inherited forms of Bone marrow failure. Hoffmans Haematology: Basic principles and practice 4th Edition, Elsevier Philadelphia. 2005:1168-1212.

Young NS, Jaroslaw PM. Chapter 25: Aplastic Anaemia. Hoffmans Haematology: Basic principles and practice. Elsevier Philadelphia. 2005:1212- 279.

Gayathri BN, Rao KS. Pancytopenia: A clinico haematological study. Physicians Lab J. 2011;3:15-20.

Khunger JM, Arculselvi S, Sharma U, Ranga S, Talib VH. Pancytopenia- a clinico- haematological study of 200 cases. Indian J Pathol Microbiol. 2002;45(3):375-9.

Tilak V, Jain R. Pancytopenia- a Clinico-hematologic Analysis of 77 cases. Indian J Pathol. 1999;42(4):399-404.

Naseem S, Varma N. Paediatric patients with bicytopenia/ pancytopenia: review of aetiologies and clinico-haematological profile at a tertiary centre. Indian J Pathol Microbiol. 2011;54:75–80.

Gupta V, Tripathi S, Tilak V, Bhatia BD. A study of clinico-haematological profiles of pancytopenia in children. 2008; 38:241-3.

Knodke K, Marwah S, Buxi G, Vadav RB, Chaturvedi NK. Bone marrow examination in cases of pancytopenia. J Academy Clin Med. 2001;2:55-9.