Introduction: Pancytopenia is a Clinico-hematological entity, characterized by a triad of Anemia, leucopenia and thrombocytopenia. The criteria for defining Pancytopenia is Hemoglobin <9 g/dl; Absolute Neutrophil count < 1.5 x 109/L and platelet count <100 x 109/L.
Objective: 1. To study the role of Bone Marrow Aspiration in etiological categorisation of Pediatric Pancytopenia’s.
2. To study Age and gender wise distribution of pancytopenia’s in children.
3. To study etiologic spectrum of various diseases with varying grades of pancytopenia.
4. To Classify Pancytopenia’s according to Bone marrow Cellularity.
5. To identify rare causes of pancytopenia’s.
Methodology: This is a 5 years study conducted in tertiary care pediatric referral hospital. For Statistical analysis , data were expressed as Mean +/ - SD and p value <0.05 is taken as statistical significant.Out of 250 bone marrow smears of pancytopenic patients studied, 70% were boys, 75% constituted Malignant diseases and 25% were benign. Incidence wise, ALL is the most common and pancytopenia being 2nd and together comprises 90% of total cases.
Discussion: Various studies done by Kumar et al, Khunger et al, Tilak et al and Khodke et al concluded that megaloblastic anemia is the commonest cause of pancytopenia followed by aplastic anemia, kalaazar and other causes. However studies conducted by Tariq14 et al concluded that aplastic anemia was the most commonest cause. The high percentage of ALL in this study is due to fact that this is terminal referral tertiary care hospital for leukaemia. The most striking feature of this study is that 72% of the total cases were leukaemias & ALL is the most common of the entire leukaemia’s comprising 62% of the total cases.Some rare cases like AML –M6 in 2 months old, MDS, Chediak higashi syndrome and Hemophagocytic syndrome(Primary HLH), LD bodies and Histoplasmosis in B.M. were noted. Flow cytometry and Molecular genetics were done were ever required.
Conclusion: Meticulous utilization of Routine FBC, blood smear and Bone Marrow Aspiration studies can help in diagnoses majority of pancytopenic cases especially in pediatric patients. Flow cytometry and Molecular genetics can be used to cover the remaining minority diagnostic challenging cases.
Novelity: ALL is most common in our study (other studies showed aplastic anemia), AML-M6 in 2 months, LD bodies in bone marrow
Keywords: Leukemia, Pancytopenia, Megaloblastic anemia, Anemia
