Publication:

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

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.