Complete clinicopathological profile and etiological spectrum of pancytopenia in adult patients attending a tertiary care referral center in Eastern India

Abstract

Introduction: Pancytopenia is a common hematological condition manifesting as a simultaneous decrease in formed elements of blood-red blood cell, white blood cell, and platelets. It happens in many illnesses, ranging from simple drug-induced bone marrow hypoplasia, megaloblastic anemia to fatal bone marrow aplasias and leukemias. Identifying the correct etiology and clinicopathological spectrum of pancytopenia helps in implementing timely and appropriate treatment. Hence, this study was undertaken for profiling pancytopenia and we chose to focus on adult patient only. Materials and Methods: The present study was an observational, cross-sectional study conducted at a tertiary care referral center in Kolkata which included 91 cases of pancytopenia over a period of 2 years. Cases were of both sexes and age >20 years who were not on any kind of drug therapy. Cases were evaluated clinically and with complete set of relevant pathological parameters. Results: In our study, the most common etiology was aplastic anemia (24.2%), followed by myelodysplastic syndrome (17.6%) and acute leukemia (14.3%). The most common age range being 21–30 years and most common symptom being progressive pallor. Anisocytosis, reticulocytosis, hypercellular marrow, and no marrow fibrosis were the most common hematological pictures. Severe pancytopenia was seen in aplastic anemia and acute leukemia. Conclusion: The present study concludes that detailed clinical history and complete hematological investigations including bone marrow studies in patients presenting with symptoms of pancytopenia are essential in understanding the disease process and to delineate the causes of pancytopenia. We found aplastic anemia to be the most common etiology in our study, consistent with the studies of Kumar et al. and Niazi et al. The following core competencies are addressed in this article: Practice-based learning and improvement, Patient care and procedural skills, Medical knowledge, and Professionalism