Bone Marrow Aspiration Evaluation in Clinical Management of Anemia Among Low Socioeconomic Group In A Tertiary Care Hospital.

Bone marrow aspiration (BMA) is a relatively safe invasive procedure by which representative sample of bone marrow is obtained through a needle aspiration for diagnostic evaluations. A total of 331 cases of anemia were profiled during the study period. The age range of patients were from 10 to 81 years. The majority of the subjects was in the adolescent age group of 10 – 19 years(20.54%). A complete blood count and peripheral smear examination in these cases revealed 125(37.76%) microcytic hypochromic anemia followed by 116(35.05%) Dimorphic anemia,23(6.95%)Pancytopenia, 23(6.95%)leukemia,31 cases (9.37%) macrocytic anemia,2 haemolytic anemia and 11(3.32%) were normocytic. These cases were further evaluated with bone marrow examination bone-marrow aspiration revealed 88 (26.59%) erythroid hyperplasia with micronormoblastic and macronormoblastic maturation(Combined deficiency),56 ( 16.92%) micronormoblastic maturation, 38 (11.48%) megaloblastic maturation, 23 ( 6.95%) Leukemia, Plasma cell myeloma 7(2.11%), lymphoma 6 (1.81%), hypoplastic marrow 5 (1.51%), haemophagocytic Lymphohistiocytosis 4 (1.21%),3 (0.91%) myelodysplastic syndrome, 2 (0.60%)cases of idiopathic thrombocytopenic purpura.In 22 (6.65%) cases the marrow was reactive. The age, sex, peripheral smear study, bone marrow aspiration study and diagnosis were collated and statistically analyzed. A definite diagnosis of plasma cell myeloma,lymphoma and myelodysplastic syndrome was possible only with bone marrow evaluation. In our study,in 77 % of cases a definite diagnosis of cause of anemia was arrived after bone marrow evaluation. 50% of cases were diagnosed with megaloblastic anemia indicating an underlying B12 and folate deficiency.