THE DIAGNOSTIC YIELD OF BONE MARROW EXAMINATION IN PANCYTOPENIA – A TERTIARY CARE EXPERIENCE

Abstract

Background: Pancytopenia is a condition characterized by the reduction of all three blood cell lines, resulting from various underlying disease processes primarily or secondarily affecting the bone marrow. Bone marrow aspiration and biopsy are essential diagnostic tools in evaluating the causes of pancytopenia.

Objective: To analyze the spectrum of bone marrow aspiration and biopsy findings in various hematological and systemic illnesses presenting with pancytopenia.

Methods: This study included both retrospective and prospective analysis of 48 patients who underwent bone marrow aspiration and biopsy at a tertiary care center over two years. Data were collected from patients attending the medicine OPD as well as inpatients. Inclusion criteria encompassed all sexes and age groups willing to give consent, while patients with bleeding disorders or those with confirmed diagnoses based on clinical profile were excluded.

Results: Of the 48 cases analyzed, 8.4% were normal, 45.8% had hematological malignancies, 43.7% had non-malignant hematological disorders, and 2% had non-hematologic disorders. Common indications for bone marrow examination included pancytopenia, anemia, leukemia, and multiple myeloma. Megaloblastic anemia was observed in 12.5% of pancytopenia cases. Among hematological malignancies, multiple myeloma (59%) and acute myeloid leukemia (18.2%) were most prevalent. Erythroid hyperplasia was present in 27% of cases, and hypoplastic marrow was seen in 8%. Bone marrow examination was crucial in diagnosing pyrexia of unknown origin when combined with other diagnostic modalities.

Conclusion: Bone marrow aspiration is a vital and invasive technique that can accurately diagnose and confirm many hematological and non-hematologic diseases. Clinical profile alone is often insufficient for diagnosis, and bone marrow examination plays a critical role in guiding physicians towards early detection and appropriate management of underlying conditions, thus improving patient outcomes.