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

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.

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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

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=

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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/gjms/17.02.1926 ◽

2019 ◽

Vol 17 (2) ◽

pp. 29-36

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

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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

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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.

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Bone marrow aspiration cytology in Abubakar Tafawa Balewa University Teaching Hospital, Bauchi State, Nigeria: Indications and diagnostic utility

Annals of African Medical Research ◽

10.4081/aamr.2019.72 ◽

2019 ◽

Vol 2 (1) ◽

Author(s):

Rufai Abdu Dachi ◽

Falmata Grema Mustapha ◽

Saleh Yuguda ◽

Modu Baba Kagu ◽

Ali Adamu Gwaram ◽

...

Keyword(s):

Bone Marrow ◽

Teaching Hospital ◽

Megaloblastic Anemia ◽

Bone Marrow Aspiration ◽

University Teaching ◽

Anatomical Site ◽

Diagnostic Utility ◽

Monitoring Tool ◽

Aspiration Cytology ◽

Hematological Diseases

Bone Marrow Aspiration (BMA) cytology is an important diagnostic and monitoring tool where cytological details of the marrow elements are examined using light microscopy. Various hematological diseases are diagnosed and monitored by using BMA. This study aimed at reporting a 3-year BMA experience of Department of Hematology and Blood Transfusion of Abubakar Tafawa Balewa University Teaching Hospital (ATBUTH) Bauchi. This was a retrospective study that involved the use of records of the bone marrow aspirates done from January 1st, 2016 to December 31st, 2018. The age, sex, indications for BMA, anatomical site and final bone marrow diagnosis were collated. The data was analyzed using SPSS Version 23.0 software. One hundred and three (103) bone marrow aspirations were performed during the period under review. Two third of the participants were males, with the median age of 40.0 years and a range of 5 months to 92 years. The commonest indication for BMA was recurrent anemia 45.6%, followed by splenomegaly, fever and lymphadenopathy with 11.7% each. While, the commonest diagnosis by BMA was megaloblastic anemia (28.2%). Mixed nutritional deficiency and Bone Marrow (BM) metastasis are the commoner BMA diagnoses with 12.6% each. Recurrent anemia is the commonest indication for BMA and nutritional anemias (megaloblastic and combined nutrients deficiency) are the commonest BMA diagnoses in Bauchi. Proper evaluation of patients by the clinicians before referral is recommended to ensure that only those that really need the procedure are subjected to it.

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Bone marrow aspiration and anemia; Diagnostic importance of bone marrow aspiration and biopsy in evaluating patients presenting with anemia of unknown etiology.

The Professional Medical Journal ◽

10.29309/tpmj/2020.27.02.4476 ◽

2020 ◽

Vol 27 (02) ◽

pp. 419-423

Author(s):

Muhammad Ihtesham Khan ◽

Asif Hussain Munir ◽

Syeda Hina Fatima

Keyword(s):

Bone Marrow ◽

Megaloblastic Anemia ◽

Bone Marrow Aspiration ◽

Bone Marrow Examination ◽

Blood Film ◽

Deficiency Anemia ◽

Unknown Etiology ◽

Cross Sectional ◽

Female Ratio ◽

Diagnostic Importance

Objectives: To determine the diagnostic importance of bone marrow aspiration and biopsy in work up of cases presenting with anemias of unknown etiology. Study Design: Cross sectional descriptive study. Setting: Pathology Department, Khyber Teaching Hospital, Peshawar. Period: July 2015 to July 2017 (two year). Material & Methods: All patients presenting with anemia (Hemoglobin less than 12gm/dL for females and 13 gm/d L for males), whose cause cannot be established on clinical history, examination and blood counts, and were thus referred for bone marrow examination for further workup were included in the study. Patients having malignancies, chemotherapy or radiotherapy associated marrow suppression, and those with diluted marrow unfit for comments were excluded from the study. Bone marrow aspiration and biopsy was done, slides were examined, and diagnoses was made and recorded. The results were drawn accordingly. Results: A total of 199 patients were referred for bone marrow aspiration, presenting with unexplained anemia, during the study period. About 12 patients had blast cells on peripheral blood film, giving diagnosis of leukemia. So they were excluded from the study. Remaining 187 cases were included in the study. The age of the study sample ranged 3 years to 63 years (mean age 42 years ±8.1 SD). There were 96 (51%) males and 91 (49%) females. Male to female ratio was 1.05:1. Out of 187 cases presenting with unexplained anemias, about 44(23.5%) cases were of iron deficiency anemia, 39(20.7%) cases were of anemia of chronic disorder, 16 (8.7%) cases as hemolytic anemia, about 19 (10.3%) cases as aplastic anemia, and 52 (27.8%) cases of megaloblastic anemia on bone marrow examination. Conclusion: Bone marrow aspiration and biopsy successfully gives the final diagnosis in cases of anemia where cause cannot be found by routine lab investigations. It helps physician decide further management plan of the patients. So, it should be done in all cases with unexplained anemia.

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Clinico-hematological study of pancytopenia

Journal of Pathology of Nepal ◽

10.3126/jpn.v2i3.6023 ◽

1970 ◽

Vol 2 (3) ◽

pp. 207-210 ◽

Cited By ~ 1

Author(s):

A Lakhey ◽

OP Talwar ◽

VK Singh ◽

Shiva Raj KC

Keyword(s):

Bone Marrow ◽

Teaching Hospital ◽

Myeloid Leukemia ◽

Hematological Malignancies ◽

Hematological Malignancy ◽

Complete Blood Count ◽

Megaloblastic Anemia ◽

Cross Sectional Study ◽

Cross Sectional ◽

Erythroid Hyperplasia

Background: Pancytopenia refers to a reduction in all the three cellular elements of blood. The aim of this study was to identify the various causes of pancytopenia in patients attending to Manipal teaching hospital in Pokhara. Materials and Methods: This was a cross-sectional study, carried out in Manipal teaching hospital from August 2008 to August 2010. Fifty-four patients with pancytopenia were included in the study. Complete blood count, bone marrow aspirations and trephine biopsies were performed. Data were analyzed using SPSS 11.0 version. Results: Out of 54 cases, there were 16 cases (29.60%) of hypoplastic bone marrow, 15 cases (27.78%) of hematological malignancies, 13 cases (24.10%) of megaloblastic anemia, 4 cases (11.11%) of erythroid hyperplasia and 6 cases (7.41%) of normcellular bone marrow. Acute myeloid leukemia was the commonest hematological malignancy. Conclusion: The commonest cause of pancytopenia in our study was hypoplastic bone marrow followed by hematological malignancies and megaloblastic anemia. DOI: http://dx.doi.org/10.3126/jpn.v2i3.6023 JPN 2012; 2(3): 207-210

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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.

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Pancytopenia: A Clinico Hematological Study

Journal of Laboratory Physicians ◽

10.4103/0974-2727.78555 ◽

2011 ◽

Vol 3 (01) ◽

pp. 015-020 ◽

Cited By ~ 34

Author(s):

Gayathri B N. ◽

Kadam Satyanarayan Rao

Keyword(s):

Bone Marrow ◽

Megaloblastic Anemia ◽

Hematological Parameters ◽

Disease Process ◽

Bone Marrow Aspiration ◽

Drug Induced ◽

Male Predominance ◽

Bone Marrow Hypoplasia ◽

Life Threatening ◽

A Prospective Study

ABSTRACT Background: Pancytopenia is a relatively common hematological entity. It is a striking feature of many serious and life-threatening illnesses, ranging from simple drug-induced bone marrow hypoplasia, megaloblastic anemia to fatal bone marrow aplasias and leukemias. The severity of pancytopenia and the underlying pathology determine the management and prognosis. Thus, identification of the correct cause will help in implementing appropriate therapy. Objectives: To study the clinical presentations in pancytopenia due to various causes; and to evaluate hematological parameters, including bone marrow aspiration. Materials and Methods: It was a prospective study, and 104 pancytopenic patients were evaluated clinically, along with hematological parameters and bone marrow aspiration in Hematology Unit, Department of Pathology, JJMMC, Davanagere, during the period of September 2005 to September 2007. Results: Among 104 cases studied, age of patients ranged from 2 to 80 years with a mean age of 41 years, and male predominance. Most of the patients presented with generalized weakness and fever. The commonest physical finding was pallor, followed by splenomegaly and hepatomegaly. Dimorphic anemia was the predominant blood picture. Bone marrow aspiration was conclusive in all cases. The commonest marrow finding was hypercellularity with megaloblastic erythropoiesis. The commonest cause for pancytopenia was megaloblastic anemia (74.04%), followed by aplastic anemia (18.26%). Conclusion: The present study concludes that detailed primary hematological investigations along with bone marrow aspiration in cytopenic patients are helpful for understanding disease process and to diagnose or to rule out the causes of cytopenia. These are also helpful in planning further investigations and management.

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Hematologic Manifestations of Vitamin B12 Deficiency in Swine

Blood ◽

10.1182/blood.v6.10.867.867 ◽

1951 ◽

Vol 6 (10) ◽

pp. 867-891 ◽

Cited By ~ 8

Author(s):

G. E. CARTWRIGHT ◽

BETTY TATTING ◽

JEAN ROBINSON ◽

N. M. FELLOWS ◽

F. D. GUNN ◽

...

Keyword(s):

Bone Marrow ◽

Vitamin B12 ◽

Liver Damage ◽

Megaloblastic Anemia ◽

Macrocytic Anemia ◽

Vitamin B12 Deficiency ◽

Deficiency Anemia ◽

Severe Neutropenia ◽

Pteroylglutamic Acid ◽

B12 Deficiency

Abstract In an effort to produce a deficiency of vitamin B12 a total of 70 pigs were fed a purified diet containing soybean alpha protein in place of casein. One group of animals was started on the diet at 2 to 7 days of age. A second group began at 21 to 28 days of age. Methionine, iodinate casein, desiccated thyroid and pteroylglutamic acid were added to the diet of certain animals and! omitted from the diet of other pigs. In addition, 9 pigs were gastrectomized. Forty-three of the animals survived for a sufficiently long period of time for adequate evaluation of the results of the experiment. Severe liver damage was observed in 24 of the 25 animals autopsied. The only animal not showing liver damage received vitamin B12 from the beginning of the experiment. Necrosis of the liver cells, fatty infiltration, or both, occurred in the presence of a high fat diet containing apparently adequate amounts of protein, choline, vitamin E and methionine. These pathologic changes were apparently prevented but not reversed by the administration of vitamin B12. Growth of the animals on the above diets without added vitamin B12 was retarded as compared with the growth of animals on the same diet supplemented with this vitamin. The administration of vitamin B12 to the deficient animals resulted in rapid growth. Of the 39 animals not receiving vitamin B12 13 failed to develop anemia, 16 developed a mild anemia and in 10 a moderately severe anemia was present. When present the anemia was normocytic and in 24 pigs was accompanied by a moderately severe neutropenia. Differential cell counts on the sternal marrow were normal except for a slight increase in the proportion of normoblasts. These hematologic alterations were neither consistently or completely corrected by the administration of vitamin B12 in spite of the fact that definite and sometimes marked reticulocyte increases followed. When methionine deficiency was associated with vitamin B12 deficiency, anemia appeared to be more severe. The administration of aureomycin, an "animal protein factor," did not stimulate growth and failed to induce a hemopoietic response. There was no macrocytic anemia, the bone marrow was not megaloblastic, and neurologic disturbances or morphologic alterations in the neutrophils were not observed. These results are in contrast to those obtained in pigs with an experimentally produced deficiency of pteroylglutamic acid. Such animals develop macrocytic anemia, leukopenia and a macronormoblastic type of bone marrow. It is not possible to give with any assurance the reason why megaloblastic anemia was not produced in the "B12-deficient" animals. This may have been due to the fact that (1) the deficiency was not sufficiently severe to result in such a change in the hemopoietic system; or (2) because pteroylglutamic acid prevents the development of megaloblastic anemia even in the absence of vitamin B12.

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