Etiological Continuum of Pancytopenia in North West Region of Pakistan

Abstract

Objectives: To find out the frequencies of different diseases causing pancytopenia based on bone marrow aspirate and biopsy. Material and Methods: Total of 126 cases were studied by examining their medical records, basic hematological investigations like Complete Blood Count (CBC), reticulocyte count, peripheral smears, bone marrow aspirates and biopsy findings. Patients were included irrespective of age groups and gender while patients on cytotoxic drugs or radiotherapy were excluded. Results: Among the 126 cases studied, age of the patients ranged from six months to 90 years with male to female ratio of 2.7:1. The maximum number 88 (70%) cases occurred below the age of 40 years, with majority of cases occurring in 2nd and 3rd decades. The most common presenting symptoms were pallor in 32 cases (25.4%) and fever in 20 cases (16%) followed by bleeding manifestations. Non-malignant etiology was seen in 85 (67.5%) patients and malignant causes were seen in 41 (32.5%) cases. Hypoplastic bone marrow was the most common cause seen in 33 (23.9%) patients, followed by megaloblastic anemia in 26 (20.63%) patients and acute leukemia in 20 (15.87%)of cases. Mean hemoglobin was 6.86 ±1.98. Mean Total leucocyte count was 2.30 ±0.948, whereas the mean platelet count was 39.40 ±31.37. Conclusion: The present study concludes hypoplastic bone marrow as the commonest cause of pancytopenia followed by megaloblastic anemia.