Etiological and clinical spectrum of pancytopenia based on bone marrow examination and case records: A retrospective study

Background : Pancytopenia is a common entity seen in clinical practice. This study aims to determine the spectrum of etiology and clinical presentation of pancytopenia by conducting a retrospective study of case records, peripheral blood smears and bone marrow aspiration/biopsy findings of patients admitted to M S Ramaiah Medical Teaching Hospital, Bangalore, India. Methods : Case records, blood smear reports and bone marrow aspiration/biopsy findings of patients presenting with pancytopenia who fit the inclusion criteria during the period of January 2010 to May 2015 were analyzed. Relevant history, physical and systemic examination and hematological parameters at presentation were recorded using a standard proforma. Results: Among 134 cases of pancytopenia at presentation mean age was 28 years. Male to female ratio was 1.16. The etiological break up was according to the following order – megaloblastic anemia (46.27%), leukemia (20.15%), aplastic anemia (9.7%), hypersplenism (7.46%), infections (6.72%), myelodysplastic syndrome (5.97%) and HIV (3.37%). The clinical spectrum in patients with each of these etiologies has been elucidated. Conclusion: The commonest cause of pancytopenia in this part of the India is megaloblastic anemia which is a curable deficiency. This is followed by leukemia, where an early diagnosis and intervention will improve their quality of life dramatically.