Etiology of Pancytopenia in Tabriz Shahid Ghazi Hospital: A Cross-sectional Study in Iran

Abstract

Objective: Pancytopenia is characterized by a reduction in all three types of blood cells: erythrocytes, leukocytes, and platelets. Pancytopenia is caused by a wide range of diseases, leading to diagnostic conundrums. These causes can range from drug reactions to life-threatening diseases such as aplastic anemia and leukemia. This study aims to investigate the causes of pancytopenia, specifically focusing on age and gender differences among patients. Methods: This cross-sectional study includes patients of all ages diagnosed with pancytopenia, as indicated by a CBC/H1 showing a WBC count less than 4,000/µL, platelet count less than 150,000/µL, and hemoglobin levels below 12 g/dL in women and less than 13 g/dL in men. The study only included patients with pancytopenia who underwent bone marrow examination and were not subjected to chemotherapy or radiation therapy. Results: A total of 133 patients with pancytopenia were included in the study. The average age was 47.35 ± 17.62 years old, with 66% of the participants being male and 34% being female. Acute leukemia, specifically acute myeloid leukemia (AML) and acute lymphoid leukemia (ALL), was identified as the primary cause of pancytopenia, accounting for 31.5% of cases. Megaloblastic anemia was the second most common cause, accounting for 30% of cases, followed by aplastic anemia at 7.5%. Conclusion: Pancytopenia, a condition marked by the decrease in both erythrocytes and leukocytes as well as thrombocytes, can arise from a myriad of causes. The main findings of this study revealed that megaloblastic anemia, acute myeloid leukemia (AML), and acute lymphoid leukemia (ALL) were the most common causes. Significantly, a considerable proportion of cases of pancytopenia can be attributed to acute leukemia. Hence, expeditious and accurate diagnosis is imperative and has the potential to save lives in such cases.