DISTRIBUTION OF NON-MALIGNANT HEMATOLOGICAL DISORDERS BY SEX, AGE GROUPS AND TYPE OF DISEASE BASED ON BONE MARROW ASPIRATION IN POPULATION OF KHYBER PAKHTUNKHWA, PAKISTAN

Background: The distribution of non-malignant hematological disorder varies across globe by sex, age groups and type of disease. The objectives of this study were to determine distribution of non-malignant hematological disorders by sex, age groups and type of disease based on bone marrow aspiration in population of Khyber Pakhtunkhwa, Pakistan. Materials and Methods: This cross-sectional study was conducted in Department of Pathology, Khyber Teaching Hospital, Peshawar, Pakistan from Jan.-Dec. 2014. 116 cases with non-malignant hematogical disorders were selected. Sex, age groups and type of disease were analyzed by count and percentage with confidence intervals for proportions. Chi-square goodness-of-fit test was used to testify two hypotheses. Results: Out of 116 cases, 63(54.31%, 80%CI 48.38-60.24) were men and 53(45.69%, 80% CI 39.76-51.62) women. Age groups wise; 31(26.72%, 80%CI 21.46-31.99) were child (≤17 years), 57(49.14%, 80%CI 43.19-55.09) young adult (18-35 years), 19(16.38%, 80%CI 11.98-20.78) middle-aged adults (36-55 years) and nine (7.76%, 80%CI 4.57-10.94) older adults (≥56 years). Frequency of type of disease was; hemolytic anemia 17(14.66%, 80%CI 10.45-18.86), megaloblastic anemia 16(13.79%, 80%CI 9.69-17.9), bone marrow hypoplasia 14(12.07%, 80%CI 8.19-15.95), iron deficiency anemia 13(11.21%, 80%CI 7.45-14.96), mixed deficiency anemia 9(7.76%, 80%CI 4.57-10.94), ITP 9(7.76%, 80%CI 4.57-10.94), aplastic anemia 8(6.89%, 80%CI 3.88-9.91), bi-liniage cytopenia 7(6.03%, 80%CI 3.2-8.87), erythroid hyperplasia 3(2.59%, 80%CI .7-4.47) and malaria 2(1.72%, 80%CI 0.18-3.27). In 18(15.52%, 80%CI 11.21-19.83) cases the bone marrow was diluted. Null hypothesis for distribution of sex (p=.3532) was accepted while that for age groups was rejected (p=

Download Full-text

DISTRIBUTION OF NON-MALIGNANT HEMATOLOGICAL DISORDERS BY SEX, AGE GROUPS AND TYPE OF DISEASE BASED ON BONE MARROW ASPIRATION IN POPULATION OF KHYBER PAKHTUNKHWA, PAKISTAN

Gomal Journal of Medical Sciences ◽

10.46903/17.02.1926 ◽

2019 ◽

Vol 17 (2) ◽

Author(s):

Mohammad Riazuddin Ghori ◽

Hamzullah Khan ◽

Muhammad Marwat

Keyword(s):

Bone Marrow ◽

Goodness Of Fit ◽

Megaloblastic Anemia ◽

Age Groups ◽

Bone Marrow Aspiration ◽

Deficiency Anemia ◽

Goodness Of Fit Test ◽

Khyber Pakhtunkhwa ◽

Hematological Disorders ◽

Erythroid Hyperplasia

Download Full-text

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

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i6.339 ◽

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

Download Full-text

MORPHOLOGICAL FEATURES OF BONE MARROW ASPIRATES IN VARIOUS TYPES OF CYTOPENIA(S) AT SAIDU TEACHING HOSPITAL, SWAT

Journal of Saidu Medical College, Swat ◽

10.52206/jsmc.2014.4.2.550-554 ◽

1969 ◽

Vol 4 (2) ◽

pp. 550-554

Author(s):

SAADIA HAROON DURRANI ◽

AMREEK LAL ◽

ZUFISHAN BATOOL ◽

MUHAMMAD SAYYAR ◽

ASHHAD HALIMI

Keyword(s):

Bone Marrow ◽

Teaching Hospital ◽

Megaloblastic Anemia ◽

Age Groups ◽

Bone Marrow Aspiration ◽

Sampling Procedure ◽

Morphological Features ◽

Teaching Hospitals ◽

Deficiency Anemia ◽

Malignant Neoplasms

OBJECTIVES: To find and document clinico-hematological features of bone marrow aspirates inpatients presenting with various forms of cytopenia(s) at Saidu Teaching Hospitals Swat.STUDY DESIGN: Descriptive study.PLACE AND DURATION OF STUDY: This study was carried out over a period of one year (1stJanuary 2013 to 31st December 2013) at Pathology department, Saidu Medical College, Saidu Sharif,Swat.METHODS AND MATERIALS: Total 200 patients of both genders and all age groups withcytopenias referred from Saidu Teaching Hospital for bone marrow cytology were included for bonemarrow aspiration and assessment.RESULTS: Two hundred patients underwent bone marrow sampling procedure. Patient’s age rangedfrom 6 months to 90 years. There were 56% male and 44% female at the ratio of 1.5:1. The mostcommon non malignant hematological condition was megaloblastic anemia 28%, mixed nutritionaldeficiency anemia 16%, hypoplasia 8%, hemolytic anemia 7%, iron deficiency anemia was present in6% cases, visceral leishmaniasis 4%, thrombocytopenia due to any cause (immune thrombocytopenicpurpura (ITP)) 2%, anemia of chronic illness was present in 2% cases, malaria and sepsis leading tocytopenia were 1% each. Malignant neoplasms in our study were 50 cases (25%), which were comprisedof; ALL 10%, AML 5%, CML 4%, MDS 3%, multiple myeloma 1.5% and lymphoproliferativedisorders in 1% cases.CONCLUSION: This study showed the pattern of morphological features on bone marrow aspiration,which was found to be different from pattern seen in European and Middle East regions and similar tothat found in Asian subcontinent.KEY WORDS: Cytopenias, pancytopenia, bicytopenia, anemia, thrombocytopenia, megaloblasticanemia, acute leukemia, myelodysplastic syndrome.

Download Full-text

Interpretation of bone marrow aspiration in hematological disorder

Journal of Pathology of Nepal ◽

10.3126/jpn.v2i4.6885 ◽

2012 ◽

Vol 2 (4) ◽

pp. 309-312 ◽

Cited By ~ 8

Author(s):

S Pudasaini ◽

KBR Prasad ◽

SK Rauniyar ◽

R Shrestha ◽

K Gautam ◽

...

Keyword(s):

Bone Marrow ◽

Megaloblastic Anemia ◽

Bone Marrow Aspiration ◽

Bone Marrow Examination ◽

Microcytic Anemia ◽

Lymphoid Leukemia ◽

Hematological Disorders ◽

Medical College ◽

Erythroid Hyperplasia ◽

Hematological Disorder

Background: Hematological disorders are quite frequent in all age group. Most of this hematological disorder first present as anemia. Bone Marrow Aspiration plays a major role in the diagnosis of its underlying cause. The aim of this study was to analyze the causes of hematological disorders, its spectrum and to interprete the bone marrow aspiration findings.Materials and Methods: This was a retrospective and prospective study carried out in the department of Pathology of Nepal Medical College in a period of two years. (July 2010 - June 2012). Bone marrow examination of 57 cases of suspected hematological disorders was carried out. All details of the patients were obtained from the record file in the department of pathology.Results: Out of 57 cases of bone marrow aspiration, erythroid hyperplasia was seen in 12 cases (21%). Megaloblastic anemia was seen in 7 cases (12.3%) and microcytic anemia was seen in 4 cases (7%). There were 6 cases (10.5%) of Idiopathic Thrombocypenic Purpura. Acute leukemia was diagnosed in 7 cases (12.3%) and among this acute myeloid leukemia (10.5%) was more common than acute lymphoid leukemia (1.8%). Myelodysplastic syndrome and multiple myeloma was seen in 3.5 % cases each. Aplastic anemia and kalaazar was seen in 5.3% and 1.8% cases respectively.Conclusion: Bone marrow examination is an important step to arrive at the confirmatory diagnosis of many hematological disorders.Journal of Pathology of Nepal (2012) Vol. 2, 309-312DOI: http://dx.doi.org/10.3126/jpn.v2i4.6885

Download Full-text

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

IP Journal of Diagnostic Pathology and Oncology ◽

10.18231/j.jdpo.2021.043 ◽

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.

Download Full-text

A prospective study on morphological alteration of megakaryocytes amongst megaloblastic anemia cases along with their clinic-haematological manifestations

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20173996 ◽

2017 ◽

Vol 5 (9) ◽

pp. 4127

Author(s):

Benazeer Mansuri ◽

Komal P. Thekdi

Keyword(s):

Bone Marrow ◽

Megaloblastic Anemia ◽

Bone Marrow Aspiration ◽

Morphological Alteration ◽

Age Group ◽

Female Ratio ◽

Hematological Disorders ◽

Common Complaint ◽

A Prospective Study ◽

Male To Female

Background: Megaloblastic anemias are hematologic disorders in which abnormal DNA synthesis causes blood and bone marrow disorders. The cause of thrombocytopenia in megaloblastic anemia has been postulated as hypoproduction in some studies, whereas ineffective thrombopoeisis has been proposed in other. Objective was to study spectrum of clinic-hematological features in megaloblastic anemia and comparative bone marrow aspiration study of thrombocytopenia secondary to megaloblastic anemia, hypoproduction and hyper-destruction. This study was done to understand the various megakaryocytic alterations in hematological disorders presenting with thrombocytopenia due to different mechanisms.Methods: Total 85 cases of thrombocytopenia included in the study. Bone marrow finding in 33 cases of thrombocytopenia of megaloblastic etiology were compared with 34 cases of marrow proven hypo productive thrombocytopenia (aplastic anemia, acute leukemia) and 19 cases of hyper destructive thrombocytopenia (immune thrombocytopenia).Results: Most common age group presenting megaloblastic anemia is 11-20 year, with male to female ratio is1.2:1, most common complaint were generalized weakness and fever. In megaloblastic anemia 24.33%, 60% and 15.67% of the cases shows increase, decrease and normal megakaryocytes respectively. Dysplastic megakaryocytes were observed in 24.3%, 27% and 20.5% of the cases of megaloblastic anemia, acute leukaemia and immune thrombocytopenic purpura respectively.Conclusions: Both hypoproduction and ineffective thrombopoiesis are the underlying path mechanisms in megaloblastic thrombocytopenia as evidenced by the marrow findings. We hereby infer that megaloblastic thrombocytopenia is to be included as a separate category apart from hypo proliferative and hyper destructive groups. The presence of dysplastic megakaryocyte should not prompt an interpretation

Download Full-text

Thrombocytopenia In Severe Anemia of Iron Deficiency

Blood ◽

10.1182/blood.v116.21.5153.5153 ◽

2010 ◽

Vol 116 (21) ◽

pp. 5153-5153

Author(s):

Getinet D. Ayalew ◽

Juhi Mittal ◽

Ratesh Khillan ◽

Miriam Kim ◽

Albert S. Braverman ◽

...

Keyword(s):

Bone Marrow ◽

Iron Deficiency ◽

African American Women ◽

Conflicts Of Interest ◽

Ferrous Sulphate ◽

Bone Marrow Aspiration ◽

Deficiency Anemia ◽

Platelet Counts ◽

Cell Counts ◽

Erythroid Hyperplasia

Abstract Abstract 5153 Introduction: Iron deficiency suppresses hemoglobin synthesis and erythropoiesis, but the resulting anemia is frequently associated with thrombocytosis. Methods: The clinical and hematologic data of seven women with severe iron deficiency anemia (IDA) and thrombocytopenia were retrospectively analyzed. Results: All patients were African-American women with symptomatic IDA, due to bleeding from uterine fibroids in 6 and from colonic diverticulosis in 1. They were 31–70 years of age, median 38. None had palpable splenomegaly. Hemoglobin ranged from 2.9–5.5, median 4.2 g/dL. MCV ranged from 57–70 fl, median 68. Absolute reticulocyte counts ranged from 19,000 – 23, 000/mm3. The initial serum ferritin ranged from 2 to 42 ng/ml, median 4. Serum iron levels ranged from 10 to 70 mcg/dl with median 30, while iron-binding capacities ranged from 381–426 mcg/dl. Serum erythropoietin (EPO) levels were >2000U/ml in two of the patients. Serum lactic dehydrogenase, bilirubin levels and liver function tests were normal; and Coombs' test negative in all cases. White blood cell counts were normal. The platelet counts ranged from 12 to 103, with a median of 46 × 109/L. Peripheral blood smears showed microcytic hypochromic red blood cells (RBC), with no evidence of platelet clumping. Bone marrow aspiration and biopsy on two patients showed increased numbers of normal megakaryocytes, erythroid hyperplasia and absent iron stores. Six patients were treated with packed RBC transfusions, and ferrous sulphate 325 mg orally was initiated at presentation in 7. Their thrombocytopenia was not treated with steroids or other agents. Three patients' platelet count reached normal or super-normal levels within 72 hours. Six patients were seen at ≥3 months after presentation, and all had achieved normal platelet counts and hemoglobin. Conclusions: These data imply that severe IDA can sometimes cause thrombocytopenia rather than thromobocytosis. We cannot be sure whether these patients' uniform normalization of platelet counts was due to treatment of their anemia by transfusion, or iron therapy. Though bone marrow megakaryocyte numbers were increased in 2 patients, there is no evidence for peripheral platelet destruction. Platelet release from megakaryocytes may have decreased in these patients. Pharmacologic EPO therapy can occasionally cause thrombocytopenia, and high endogenous EPO levels in our patients may have reduce their platelet counts. This conclusion is consistent with their apparent response to transfusion. Though the pathogenesis of IDA-associated thrombocytopenia is not known, our data suggest that the results of anemia and iron deficiency treatment should be evaluated before investigating thrombocytopenia as an independent problem. Disclosures: No relevant conflicts of interest to declare.

Download Full-text

Study of megakaryocytes in bone marrow aspiration smears in patients with thrombocytopenia

Journal of Pathology of Nepal ◽

10.3126/jpn.v3i6.8997 ◽

2013 ◽

Vol 3 (6) ◽

pp. 476-481 ◽

Cited By ~ 2

Author(s):

PK Choudhary ◽

SK Sing ◽

RB Basnet

Keyword(s):

Bone Marrow ◽

Acute Leukemia ◽

Myelodysplastic Syndrome ◽

Megaloblastic Anemia ◽

Hematological Parameters ◽

Bone Marrow Aspiration ◽

Common Occurrence ◽

Thrombocytopenic Purpura ◽

Hematological Disorders ◽

Mere Presence

Background: Dysplastic changes in megakaryocyte are well-recognized features of myelodysplastic syndrome. However, several studies have shown it’s occurrence in various other disorders. This study was done to understand the various megakaryocytic alterations including the dysplastic forms in hematological disorders presenting with thrombocytopenia other than in myelodysplastic syndrome. Materials and Methods: All cases of thrombocytopenia in the study period of May 2010 to April 2012 were included. Bone marrow aspiration study was done in each case of thrombocytopenia. Megakaryocytes were examined in bone marrow aspiration smears in terms of their number and morphology. Dysplasia was considered significant if ≥ 10% of megakaryocyte examined show dysplastic morphology. Results: Dysplastic megakaryocytes were observed in 52.3%, 50% and 21.2% of the cases of megaloblastic anemia, acute leukemia and immune thrombocytopenic purpura respectively. Most common dysplastic feature observed were multiple separate nuclei (25.2%) and micromegakaryocyte (17.3%). Hypogranular form was the least observed dysplastic feature (1.4%; 2/139 cases). Conclusion: Dysplasia in megakaryocyte is a quiet common occurrence in various non-myelodysplastic syndroms related thrombocytopenia. The mere presence of dysplastic megakaryocyte should not prompt an interpretation of myelodysplastic syndroms and should always be correlated with patient’s clinical and other hematological parameters. DOI: http://dx.doi.org/10.3126/jpn.v3i6.8997 Journal of Pathology of Nepal (2013) Vol. 3, 476-481

Download Full-text

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

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20183125 ◽

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.

Download Full-text

Spectrum of benign and malignant hematological diseases diagnosed in Quetta on bone marrow aspiration.

The Professional Medical Journal ◽

10.29309/tpmj/2020.27.03.4210 ◽

2020 ◽

Vol 27 (03) ◽

pp. 641-645

Author(s):

Ayesha Samad Dogar ◽

Tariq Mehmood Marri ◽

Hafiz Ather Farooq

Keyword(s):

Bone Marrow ◽

Chronic Myeloid Leukemia ◽

Aplastic Anemia ◽

Myeloid Leukemia ◽

Acute Lymphocytic Leukemia ◽

Megaloblastic Anemia ◽

Bone Marrow Aspiration ◽

Lymphocytic Leukemia ◽

Male Population ◽

Hematological Disorders

Objectives: Bone marrow aspiration is a diagnostic test for various hematological disorders. Present study was designed to determine the percentages and frequency of benign and malignant hematological disorders diagnosed on bone marrow aspiration in Quetta. Study Design: Cross sectional study. Setting: Department of Hematology Sandeman Provincial Teaching Hospital Quetta and Bolan Medical Complex Quetta. Period: From Jan 2015 to Jan 2019. Material & Methods: The demographic variables were age and gender of the patients, while the research variables were benign hematological disorders and malignant hematological disorders. All the variables were presented in percentages and frequencies. Results: Out of total 478 hematological disorders 241(50.4%) were diagnosed with benign and 237(49.6%) were malignant hematological disorders. Majority of the patients were in the age range between 1-10 years. 62.3% was the male population whereas females comprised of only 37.7%. Megaloblastic Anemia having 14.2% was found to be the most common benign hematological disorders followed by Aplastic Anemia with 11.7% cases and Idiopathic Thrombocytopenic Purpura was present in 9.2%. Among the malignant disorders Acute Lymphocytic Leukemia 19%, Chronic Myeloid Leukemia 8.3% and Acute Myeloid Leukemia were found to be 5.8%. Conclusion: The most common benign hematological disorders were Megaloblastic anemia and Aplastic anemia whereas Acute Lymphocytic Leukemia and Chronic Myeloid Leukemia were the most remarkable malignant hematological disorder diagnosed on bone marrow aspiration in Quetta.

Download Full-text