Etiological Spectrum of Bone Marrow Biopsy in Patients With Pancytopenia

Abstract

Background Pancytopenia is defined as a decrease in all three hematologic cell lines. The condition is not a disease in itself but a common pathway caused by various etiologies that can be infectious, autoimmune, genetic, nutritional, and/or malignant. Determining the cause of pancytopenia is a challenge and is key in determining the proper treatment regimen and estimating prognosis. Objective The aim of this study was to evaluate the etiological spectrum of pancytopenia in patients who underwent bone marrow biopsy at a tertiary care hospital. Methodology This study was conducted at the Internal Medicine and Gastroenterology Departments of Lady Reading Hospital, Peshawar, Pakistan, from January 1, 2023, to December 31, 2023. A total of 120 patients with pancytopenia aged 12 to 60 years who underwent bone marrow biopsy were enrolled. Data on age, gender, clinical presentations, and bone marrow biopsy findings were observed. Results The mean age was 34.97 years. Males were more frequently affected, 74 (61.7%), than females, 46 (38.3%). Pallor, 86 (71.7%), and weakness, 66 (55.0%), were the most frequent presentations of pancytopenia. The etiological spectrum showed that megaloblastic anemia was present in 48 (40%) of the cases, followed by infection-related changes in 20 (16.7%) and aplastic anemia in 20 (16.7%). Conclusion Megaloblastic anemia emerged as the leading cause of pancytopenia in our study, followed by aplastic anemia and infection-related changes.

Keywords: aplastic anemia; biopsy; bone marrow biopsy; bone marrow failure; megaloblastic anemia; pancytopenia; thrombocytopenia; thrombocytopenia pancytopenia.