scholarly journals Clinico-Haematological Study of Pancytopenia – An Experience from a Tertiary Care Centre in Western Odisha

2021 ◽  
Vol 8 (24) ◽  
pp. 2052-2057
Author(s):  
Anupa Toppo ◽  
Harish Chandra Singh ◽  
Rojalin Nanda
Keyword(s):  
Bone Marrow ◽  
Aplastic Anaemia ◽  
Tertiary Care ◽  
Disease Process ◽  
Bone Marrow Aspiration ◽  
Megaloblastic Anaemia ◽  
Care Hospital ◽  
Haematological Malignancies ◽  
Female Ratio ◽  
Haematological Disorders

BACKGROUND Pancytopenia is a relatively common haematological entity with simultaneous presence of anaemia, leucopenia and thrombocytopenia. It is a feature of many medical and haematological disorders like megaloblastic anaemia, drug-induced bone marrow hypoplasia, even fatal leukaemia and bone marrow aplasia. The clinical and haematological studies determine the proper diagnosis and management of patients. Bone marrow examination is an important diagnostic procedure for determining the cause of pancytopenia. This study was conducted to evaluate clinico-haematological findings, identify the causes of pancytopenia, and compare our findings with other similar studies. METHODS The four-year retrospective study was carried out in the Department of Pathology at a tertiary care hospital in western Odisha, India. Data regarding clinical details, peripheral blood and bone marrow aspirations were collected and analyzed using simple statistical methods. RESULTS A total of 131 cases of pancytopenia were studied. The age range of patients was 3 years to 72 years, with a mean of 36.5 years. Male to female ratio was 0.84 : 1. The majority of cases were in the age group of 31 – 40 years (20.61 %). Generalized weakness with pallor (54.96 percent) was the commonest clinical finding, followed by splenomegaly (16.79 %), and hepatomegaly (11.45 %). Aplastic anaemia (43.51 %) was the most common cause found on the bone marrow aspiration followed by megaloblastic anaemia (22.14 %) and haematological malignancies. Among the haematological malignancies, acute myeloid leukaemia was the commonest cause of pancytopenia (10.69 %). CONCLUSIONS Bone marrow aspiration in cytopenic patients helps in understanding the disease process and to diagnose or rule out the causes of cytopenia. Different geographical areas have a different presentation of haematological disorders. KEYWORDS Bone Marrow Aspiration, Pancytopenia, Aplastic Anaemia

scholarly journals HAEMATOLOGICAL DISORDERS DIAGNOSED IN ONE HUNDRED AND ONE SUCCESSIVE BONE MARROW EXAMINATION AT A TERTIARY CARE CENTRE IN QUETTA, BALOCHISTAN

2021 ◽  
Vol 71 (2) ◽  
pp. 672-75
Author(s):  
Sunila Tashfeen ◽  
Naveed Asif ◽  
Shafia Nasir ◽  
Muhammad Azam ◽  
Zareen Irshad
Keyword(s):  
Bone Marrow ◽  
Tertiary Care ◽  
Bone Marrow Aspiration ◽  
Unknown Origin ◽  
Bone Marrow Examination ◽  
Military Hospital ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Female Ratio ◽  
Haematological Disorders

Objective: To determine the frequency of haematological disorders diagnosed by bone marrow examination at a tertiary care centre in Quetta, Balochistan. Study Design: Prospective observational study. Place and Duration of Study: Department of Pathology, Combined Military Hospital Quetta, from Jan 2018 to May 2019. Methodology: A total of 101 one patients, who underwent bone marrow examination, were included in the study. Brief history, clinical examination and indication of procedure were also endorsed in a questionnaire designed for the study. Results: Bone marrow of one hundred and one patients, included in the study, were evaluated. Mean age of the patients was 32.3 ± 18.4 years. There were 68 males (67%), while 33 were females (33%) with 2:1 male to female ratio. Pyrexia of unknown origin (PUO) was the most common indication for bone marrow examination with frequency of 20.7%. Nutritional anaemia was the most prevalent benign disorder (17%), whereas Acute Lymphoblastic leukaemia (ALL) accounted about 6.8% which is highest in malignant disorders. Conclusion: This study has concluded that bone marrow examination is a useful technique and findings of bone marrow can modify the treatment. Thus procedure has a great diagnostic value. Both bone marrow aspiration (BMA) and bone marrow biopsy (BMB) are the complimentary techniques and supremacy of one method on other depends on the disorder.

scholarly journals Bone marrow aspiration in haematological disorders: study at a tertiary care centre

2018 ◽  
Vol 6 (7) ◽  
pp. 2361
Author(s):  
Subuh Parvez Khan ◽  
Sajad Geelani ◽  
Shareefa Akhter ◽  
Shuaeb Bhat ◽  
Saleem Hussain ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Megaloblastic Anemia ◽  
Tertiary Care ◽  
Test Procedure ◽  
Bone Marrow Aspiration ◽  
Bone Marrow Examination ◽  
Invasive Technique ◽  
Tertiary Care Centre ◽  
Female Ratio ◽  
Haematological Disorders

Background: The bone marrow examination is an essential investigation for the diagnosis and management of many disorders of the blood and bone marrow. Bone marrow aspiration (BMA) alone is usually sufficient to diagnose nutritional anaemias, and most of the acute leukaemias. Aim was to study the spectrum of haematological disorders diagnosed on bone marrow aspiration.Methods: This study was conducted in the Department of Clinical Haematology in Sher e Kashmir Institute of Medical Sciences, Kashmir for a period of 2 years from December 2015 to December 2017. Bone marrow examination of 2131 cases of suspected hematological disorders was carried out. Bone marrow was aspirated from posterior superior iliac spine under local anaesthesia. Aspirates of dry tap were excluded from the study. Aspiration smears where stained with Leishmann stain for morphological examination.Results: A total of 2131 cases were included in this study. Male to female ratio in our study was 1.9:1. The age range of cases was from 1-80 years and the mean age was 47.3 years. Anemia was the most common haematological disorder in our study accounting for 25.6% of cases followed by acute leukaemia accounting for 22.3% and multiple myeloma (13.3%). Among anemias, megaloblastic anemia was most common followed by dual deficieny anemia. Among leukaemias, acute myeloid leukaemia (13.2%) was more common than acute lymphoblastic leukaemia (9.1%).Conclusions: Bone marrow aspiration cytology is a mildly invasive technique which can diagnose many hematological and non-hematologic diseases that can be confirmed by more advanced investigations viz. serological, biochemical or molecular. It is a highly informative test procedure performed for evaluating blood and blood related diseases in our environment.

scholarly journals A study on incidence of vitamin B12 deficiency in patients with pancytopenia

2019 ◽  
Vol 6 (5) ◽  
pp. 1402
Author(s):  
G. Sathish Kumar ◽  
Swetha . ◽  
V. Rajendran
Keyword(s):  
Bone Marrow ◽  
Vitamin B12 ◽  
Hematological Parameters ◽  
Vitamin B12 Deficiency ◽  
Disease Process ◽  
Bone Marrow Aspiration ◽  
Megaloblastic Anaemia ◽  
Clear Understanding ◽  
Female Ratio ◽  
B12 Deficiency

Background: Pancytopenia is a serious and life threatening illness presented with multiple etiologies. The current study was done with the objective to evaluate the clinic-pathological factors responsible for incidence of pancytopenia in patients with vitamin B12 deficiency and their response to the therapy with vitamin B12.Methods: It was an observational study carried out at Department of Medicine, Mahatma Gandhi Memorial Government Hospital, Trichy, Tamilnadu during the period between December 2016 to December 2017. A total 50 patients with pancytopenia were clinically evaluated along with hematological parameters and bone marrow aspiration.Results: A total of 50 patients were included in the study. The mean age of the patients was 32.84 years with a male to female ratio of 1.5:1. All patients had history of fatigability. Commonest physical presentation was pallor (100%). Megaloblastic anaemia was the predominant blood picture in 58% patients. The common bone marrow finding was hyper cellular marrow with megaloblastic picture. Management with cyanocobalamin preparations and folate supplementations, significantly improved the reticulocyte count percentage in patients with pancytopenia (p=0.01)Conclusion: The study concluded that the most common cause of pancytopenia was megaloblastic anaemia. Detailed haematological investigations along with bone marrow aspiration in patients with cytopenia provided a clear understanding of disease process to identify the etiologies of pancytopenia.

scholarly journals DIAGNOSTIC IMPORTANCE OF BONE MARROW ASPIRATION IN HEMATOLOGICAL DISORDERS – TERTIARY CARE CENTRE BASED STUDY.

2019 ◽  
Vol 3 (6) ◽  
Author(s):  
Seema Meena ◽  
Sukriti . ◽  
Sonal Bhati ◽  
Abha Patni
Keyword(s):  
Bone Marrow ◽  
Megaloblastic Anemia ◽  
Tertiary Care ◽  
Bone Marrow Aspiration ◽  
Deficiency Anemia ◽  
Invasive Technique ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Female Ratio ◽  
Hematological Disorders

Background: Bone marrow aspiration (BMA) is a minimally invasive technique performed in a variety of hematological disorders. It is considered essential for the diagnosis and management of haematological disorders. BMA is usually sufficient to diagnose nutritional anemia and most of the leukemias. Aims & Objectives: To study the spectrum of hematological disorders diagnosed on BMA in a tertiary care centre, Udaipur. Material & Methods:  The present study was conducted in the hematology section of department of Pathology, RNT Medical College & MB Hospital, Udaipur for a period of one year from June 2018 to May 2019. A total of 123 cases of suspected hematological disorders underwent the process of BMA from posterior superior iliac spine under local anesthesia. Exclusion criteria of our study included aspirates of dry tap. BMA smears were stained with Giemsa stain for morphologic examination. Result: The present study included 123 cases. Male to female ratio in our study was 1.6:1. Anemia (45.5%) was the most common hematological disorder in our study, iron deficiency anemia being the most common followed by megaloblastic anemia. Chronic myeloid leukemia (26.01%) was the most common hematological malignancy in our study. Conclusion: Bone marrow aspiration is a useful diagnostic procedure in hematological practice for the diagnosis of both hematological and non-hematological conditions. Rapid and early diagnosis of malignancies are critical for proper initiation of treatment and to control the disease. Keywords: Bone Marrow Aspiration, Hematological disorders, Leukemias

A comparative study of bone marrow aspirate with trephine biopsy in pancytopenia disorders

2021 ◽  
Vol 6 (3) ◽  
pp. 201-206
Author(s):  
Kavya J ◽  
Kalpana Kumari MK
Keyword(s):  
Bone Marrow ◽  
Sensitivity And Specificity ◽  
Megaloblastic Anemia ◽  
Tertiary Care ◽  
Bone Marrow Aspiration ◽  
Bone Marrow Examination ◽  
Care Hospital ◽  
Trephine Biopsy ◽  
Hematological Disorders ◽  
Hematoxylin And Eosin

Pancytopenia is commonly reported in clinical hematology practice. Due to its varied marrow pathology and underlying ailments, diagnosis is often misleading and delayed. Bone marrow examination would provide a comprehensive diagnosis of both blood and bone marrow, since aspirate investigates the cytological morphology and biopsy evaluates the cellularity, architecture, and compact marrows.To compare bone marrow aspiration and trephine biopsy results in the diagnosis of pancytopenia, and to determine the sensitivity and specificity of aspirate examination in pancytopenia diagnosis.This prospective study was conducted at a tertiary care hospital from July 2014 to June 2016. A total of 320 samples were received at the department of pathology for bone marrow examination (aspirate and biopsy). Romanowsky (Leishman) stain was used to investigate aspirate samples. All biopsy samples were processed into 3-5 μ blocks and stained using hematoxylin and eosin after decalcification with 5.5% EDTA. Data analysis was performed using SPSS19.Pancytopenia constituted 56 (18.7%) cases with the mean age of 41.79 years. Of the total pancytopenia cases, hematological disorders constituted 50 (89.3%) cases and 6 (10.7%) were non-hematological cases. Aspirate and biopsy diagnosis positively correlated in 76.79% of cases. A 100% sensitivity and specificity of aspirate diagnosis was observed in, acute myeloid leukemia, hypersplenism, myelodysplastic syndrome, megaloblastic anemia, hematological malignancy in remission and negative for lymphoma infiltrate. Aspirate had no role in diagnosis of uremic osteodystrophy and myelofibrosis, whereas leishmaniasis was diagnosed on aspirate alone.Pancytopenia includes multiple underlying ailments which requires a differential diagnosis approach. Combining both aspirate and biopsy for diagnosis would benefit the patient in prognosis as they are complementary to each other.

scholarly journals Study of etiological spectrum and clinical profile of patients admitted in tertiary care hospital of South Gujarat, India

2020 ◽  
Vol 7 (4) ◽  
pp. 616
Author(s):  
Mohnish M. Patel ◽  
K. N. Bhatt ◽  
Khyati T. Jariwala
Keyword(s):  
Bone Marrow ◽  
Tertiary Care ◽  
Peripheral Blood Smear ◽  
Megaloblastic Anaemia ◽  
Care Hospital ◽  
Peripheral Smear ◽  
Normal Reference Range ◽  
Common Cause ◽  
Etiological Spectrum ◽  
Bone Marrow Study

Background: Pancytopenia is defined as reduction of all three formed elements of blood below normal reference range. The symptoms are fatigue, fever, dizziness and weight loss. Evaluation was done using complete hemogram and peripheral smear. The presenting marrow biopsy is most useful and accurate in evaluation of pancytopenia.Methods: Two ml of anticoagulated blood was collected for complete hemogram. The peripheral blood smear was stained with Leishman's stain and studied. Bone marrow biopsy and aspiration was done in all the patients to identify etiology.Results: Predominance was seen in the age group of 31-60 years. Most common cause of pancytopenia was megaloblastic anaemia in this study compared to other studies all over the world where most common cause was aplastic anaemia. This reflects higher prevalence of megaloblastic anaemia in the Indian subjects.Conclusions: A comprehensive clinical, haematological land bone marrow study of patients with pancytopenia usually helps in identification of the underlying cause.

scholarly journals Evaluation of pancytopenia on bone marrow aspiration- study at a tertiary care center in Kashmir valley, India

2018 ◽  
Vol 5 (4) ◽  
pp. 946
Author(s):  
Subuh Parvez Khan ◽  
Sajad Geelani ◽  
Fiza Parvez Khan ◽  
Noorjahan Ali ◽  
Shazieya Akhter ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Megaloblastic Anemia ◽  
Care Center ◽  
Tertiary Care ◽  
Disease Process ◽  
Bone Marrow Aspiration ◽  
Deficiency Anemia ◽  
Total Leucocyte Count ◽  
Tertiary Care Center ◽  
Kashmir Valley

Background: Pancytopenia refers to combination of anaemia, leukopenia and thrombocytopenia. It may be a manifestation of a wide variety of disorders, which primarily or secondarily affect the bone marrow. However, aetiology of pancytopenia varies from one geographical region to another. Bone marrow aspiration plays an important role in identifying the cause of pancytopenia. This study was carried to identify the causes of pancytopenia and to find out the bone marrow morphology in cases of pancytopenia.Methods: This study was conducted in the department of haematology in a tertiary care center in Kashmir valley for a period of 3 years. Inclusion criteria: cases with hemoglobin less than 10 gm/dl, total leucocyte count of less than 4000/mm3 and platelet count less than 100,000/mm3 were included in the study.Exclusion criteria: Patients receiving chemotherapy/radiotherapy were excluded from the study. Bone marrow aspiration (BMA) was performed from posterior iliac crest of the patients. Bone marrow aspiration smears were stained with Leishman stain for microscopy.Results: A total of 334 cases were studied during a period of 3 years. Age of patients ranged from 1 year to 85 years with mean of 43.59 years.180 cases were male, and 154 cases were female with male:female ratio of 1.2 :1. The commonest cause of pancytopenia was megaloblastic anemia seen in 103 cases (30.8%) followed by dual deficiency anemia seen in 69 cases (20.7%).37 cases (11%) were of acute leukaemia. Aplastic anemia was seen in 35 cases(10.5%). Other causes of pancytopenia were myelodysplastic syndrome, multiple myeloma, iron deficiency anemia and hypersplenism.Conclusions: Bone marrow aspiration in patients of pancytopenia helps in the identification of the underlying cause in most of the cases. BMA is helpful for understanding the disease process; and in planning further investigations and management of cytopenia patients. 

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