Evaluation of Bone Marrow Biopsy in Pancytopenia-An Institutional Understanding | Chapter 7 | Medicine and Medical Research: New Perspectives Vol. 12

Background: Pancytopenia is not a disease entity, but a triad of findings, resulting from various disease processes. It is characterized by anaemia, leucopenia and thrombocytopenia in the peripheral blood. It is a relatively common phenomenon in daily medical practice and one of the most common reasons for consultation from hematologists. Bone marrow examination is of utmost importance in the evaluation of pancytopenia and thereby identification of the disease process is helpful for appropriate management.

Aims: The aim of the study is to analyse a wide spectrum of haematological diseases giving rise to pancytopenia in bone marrow trephine biopsy.

Materials and Methods: This was a prospective study conducted in the department of Pathology and Clinical Hematology, S.C.B. Medical College, Cuttack for a period of 2 years including 122 pancytopenia patients. Complete blood count including peripheral smear examination, followed by bone marrow aspiration (BMA) and trephine biopsy were carried out in all cases. A detailed study of bone marrow examination was done and diagnoses were established in all the pancytopenia cases. All the relevant data were compiled and analysed for further investigation and planning.

Results: Pancytopenia often creates a diagnostic challenge for clinicians. Identification of the accurate cause is crucial in the management of these patients. Among 122 patients studied, 63.1% were males and 36.9% females. Aplastic anaemia was the commonest cause of pancytopenia (51%) followed by megaloblastic anaemia (23%). Other causes include acute leukaemia 9%, MDS 6%, primary myelofibrosis 2%, lymphomatous infiltration in the marrow 2%, and multiple myeloma 3%. Metastatic deposit, tuberculosis, haemophagocytic syndrome and hypersplenism constituted 1% each.

Conclusion: BMA and biopsy were diagnostic in all the cases of pancytopenia. Though in a few cases, BMA yields a dry tap and inconclusive coupled with bone marrow biopsy (BMB) it helps in defining diagnostic and therapeutic strategies in pancytopenia. The present study concluded that the most common cause of pancytopenia is aplastic anaemia, followed by megaloblastic anaemia and acute leukemia.

 

Author (s) Details

Rati Ranjan Swain
DHH, Angul, Odisha, India.

 

Sandhya Rani Sahoo
SJMCH, Puri, Odisha, India.

 

Sudha Sethy
Department of Clinical Hematology, SCB MCH, Cuttack, India.

 

Pranati Mohanty
Department of Pathology, GMCH, Sundargarh, Odisha, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/mmrnp/v12/2167

Clinico Haematological Profile in Paediatric Patients with Bicytopenia and Pancytopenia in a Tertiary Care Referral Centre of North India: A Prospective Observational Study | Chapter 03 | Current Aspects in Pharmaceutical Research and Development Vol. 7

 Background: When compared to paediatric patients, bicytopenia and pancytopenia are very typical presentations in adults. Pancytopenia/Bicytopenia manifests itself in a variety of ways in children, ranging from temporary bone marrow suppression to marrow invasion by life-threatening cancers. The findings in the bone marrow might range from normocellular with non-specific alterations to hypercellular with malignant cells overshadowing it, depending on the underlying reasons.

The goal of this study is to look at the clinical and haematological profiles of children with Cytopenias. The goal of this study is to determine the severity of haematological findings in patients with Pancytopenia and Bicytopenia based on the causal variables.

Methods: A prospective observational study was undertaken at Dr. RPGMC Tanda Himachal Pradesh's Department of Paediatrics (INDIA). All patients were included in the trial, with the exception of those who met the exclusion criteria. It was carried out after receiving verbal and written informed consent. From March 2013 to March pancytopenia, a total of 50 children with bicytopenia and pancytopenia were enrolled. Infection caused bicytopenia in 14 (20%) and pancytopenia in 8 (16%) of the cases. Scrub typhus was the most frequent infection in 1890. (32 percent ). Leukemia was found in 11 (22% of the cases).

Conclusions: The most common age group affected was 11-15 years old, with female dominance at a ratio of 0.78:1. Fever was the most prevalent symptom in 37 percent of cases, followed by widespread weakness in 29 percent of cases. Pallor was the most prevalent symptom in 43 (86%) of the patients, followed by hepatomegaly in 32 (64%), lymphadenopathy in 30 (60%), and splenomeagly in 29 (58%). The most common cause was infection, followed by leukaemia and megaloblastic anaemia. Scrub typhus was the most prevalent infection found in this investigation.

Author(S) Details

Pankaj Katoch
Department of Microbiology, IGMC, Shimla, India.

Vipin Roach
Department of Pediatrics, IGMC, Shimla, India.

Surinder Singh
Department of Pediatrics, IGMC, Shimla, India.


View Book:- https://stm.bookpi.org/CAPRD-V7/article/view/5411

The Role of IRF (Immature Reticulocyte Fraction) in Pancytopenia | Chapter 16 | Recent Developments in Medicine and Medical Research Vol. 11

 Background: Pancytopenia is a common ailment that manifests itself in a variety of ways around the world. Primary investigations for evaluating and diagnosing the causes of pancytopenia include bone marrow aspiration and biopsy. However, before performing a bone marrow aspiration or biopsy, it's worth noting that the newer reticulocyte indices, such as reticulocyte percent and absolute reticulocyte count, provided by automated cell counters, can help us get a better picture of marrow erythropoietic activity while avoiding inter-observer variability. The Immature Reticulocyte Fraction (IRF), Reticulocyte Hemoglobin Content (CHr or Ret-He), and the differential between reticulocyte and erythrocyte haemoglobin content are some of the newer reticulocyte indices (Delta-He). IRF was first used to track hematopoietic treatment in children with pancytopenia caused by cancer chemotherapy. We tried to emphasise the importance of Immature Reticulocyte Fraction (IRF) above other reticulocyte indices in pancytopenia diagnosis and therapy response assessment.

The history of the patients was taken in this investigation. Then, using Automated Cell Counters (Sysmex XT-4000i), EDTA mixed blood was studied, followed by a bone marrow investigation to validate the cause. The results were statistically calculated.

We discovered that IRF levels were also important in the diagnoses of Megaloblastic Anaemia, Aplastic Anaemia, early Marrow Recovery after Suppression, Hemolytic Disease, and Chronic Diseases.

Conclusion: The absolute reticulocyte count is a quantitative indicator of the efficacy of erythropoiesis, and the IRF is thought to be an index of acceleration. As a result, after starting treatment, monitoring both IRF and Reticulocyte Count on a regular basis may be beneficial in determining the efficacy of the treatment.

Author(S) Details

Suchandra Ray
Department of Pathology IPGME&R, Kolkata, West Bengal, India.

Chhanda Das
Department of Pathology IPGME&R, Kolkata, West Bengal, India.

Sudip Roy
Department of Pathology IPGME&R, Kolkata, West Bengal, India.

View Book:- https://stm.bookpi.org/RDMMR-V11/article/view/4658

Etiological Evaluation of Pancytopenia in a Tertiary Care Hospital: A Prospective Study | Chapter 12 | Issues and Development in Health Research Vol. 4

 Background: Pancytopenia is a common haematological problem characterised by the presence of anaemia, leucopenia, and thrombocytopenia all at the same time. The disease pattern linked with pancytopenia varies depending on geographic area, age group, nutritional status, drug intake, and infective condition prevalence. The purpose of this prospective study was to investigate and discover possible causes of pancytopenia, as well as to determine the percentage of people who have pancytopenia, as well as to compare the findings with those of other similar studies. From June 2012 to June 2014, 80 patients with pancytopenia were clinically assessed at Justice K. S. Hegde Hospital, Nitte University, Deralakatte, Mangalore, with full blood counts, peripheral smears, and bone marrow aspiration-biopsy whenever possible. Results: The majority of the 80 cases studied were in the 41-50 year age range, with a male predominance. The three most common reasons in our hospital were hypersplenism (28.75 percent), malaria (16.25 percent), and megaloblastic anaemia (13.75 percent). Plasmodium vivax (8 instances) was the most prevalent parasite found in 13 cases of malaria. Conclusion: Different causes of pancytopenia can be related to geographic location, nutritional and pharmacological intakes, personal habits, infectious causes, diagnostic criteria stringency, and variances in methodology used, according to the current study. Thus, in the comprehensive workup of patients with pancytopenia, a detailed clinical history and meticulous examination, as well as haematological assays, give vital information for understanding disease processes, planning additional investigations and management, and determining the cause.

Author(s) Details

Anuja Dasgupta
Deptartment of Pathology, Akash Institute of Medical Sciences and Research Centre, Devanahalli, Bengaluru, India.

Shetty K. Padma
Deptartment of Pathology, K.S Hegde Medical Academy, NITTE University, Deralakatte, Mangalore, India.


K. Sajitha
Deptartment of Pathology, K.S Hegde Medical Academy, NITTE University, Deralakatte, Mangalore, India.


Jayaprakash Shetty
Deptartment of Pathology, K.S Hegde Medical Academy, NITTE University, Deralakatte, Mangalore, India.



View Book :- https://stm.bookpi.org/IDHR-V4/article/view/3380