Original Research Article Indian Journal of Pathology and Oncology, April-June 2016;3(2);247-254 247 Clinical correlation of pancytopenia with bone marrow study in a tertiary hospital Sheetal Mahesh Sale 1 , Vaibhav Pandurang Mane 2,* , Vishrabdha Rahul Pawar 3 , Sushant Narayan Mohite 4 , Vanisha Dhaka 5 1 Assistant Professor, 2 Associate Professor, 3 Professor, 4,5 Junior Resident, Bharati Vidyapeeth Deemed University Medical College & Hospital, Sangli *Corresponding Author: Email: vaishnavilab@rediffmail.com Abstract Introduction: Pancytopenia is reduction in all three major formed elements of blood: erythrocytes, leucocytes and platelets. It has been observed in Indian scenario that megaloblastosis –Vit. B 12 and folate deficiency is the commonest cause of pancytopenia. However, the frequency with which each condition is associated with pancytopenia differs considerably depending upon various factors including geographic distribution. Objectives: 1.To study the frequency of pancytopenia in patients admitted in tertiary hospital. 2. To correlate the clinical findings, haemogram, bone marrow aspirate and / or bone marrow trephine biopsy. Material and Methods: This retrospective study was carried out over a period of three years in the department of pathology at tertiary hospital from Jan 2012 to Dec.2015 .In this period, a total of 60 bone marrow examinations that fulfilled the criteria for pancytopenia were studied. Results: Total 60 cases were studied in the given period. The most common cause of pancytopenia was Megaloblastic anemia followed by aplastic/Hypoplastic anemia. Commonest age group of presentation of pancytopenia was between 21-30 years, male to female ratio being 0.9:1.Pallor was the most common clinical feature. Conclusion: Among the conditions that causes Megaloblastic anemia due to Vit. B12/Folate deficiency, i.e. nutritional in origin seems to reflect the higher prevalence of pancytopenia in Indian subjects-which is easily reversible. Keywords: Pancytopenia, bone marrow examination, megaloblastic anemia, iron stores, Aplastic anemia, vitamin B12. Access this article online Quick Response Code: Website: www.innovativepublication.com DOI: 10.5958/2394-6792.2016.00048.X Introduction Pancytopenia” is reduction in all three major classifications of formed elements of blood: erythrocytes, leucocytes and platelets. It is the simultaneous presence of anemia, leucopenia and thrombocytopenia. Thus, it is not an entity by itself, but a triad of finding that may result from number of disease processes 1,3 . Present study was carried out mainly with the twin aims of diagnosing the patients with Pancytopenia and finding out the common disease entities responsible for it. 6,9 Pancytopenia develops due to decrease in hematopoietic cell production in bone marrow as a result of destruction of marrow tissue by toxins (aplastic/ hypoplastic marrow), replacement by abnormal or malignant tissue or suppression of normal marrow growth and differentiation. In other situations, however, the marrow may be normally cellular or even hypercellular and no abnormal cells may be present. The mechanism leading to pancytopenia in such patients are thought to include ineffective hematopoesis with cell death in marrow, formation of defective cells that are rapidly removed from the circulation, sequestration or destruction of cells by the action of antibodies and trapping normal cells in a hypertrophied and overactive reticuloendothelial system 3 . Criteria applied by people varied in different series. DeGruchy gives the criteria as hemoglobin (Hb) level below 13.5 gm/dl for males and 11.5 gm/dl for females, total leucocytes count (TLC) below 4000/mm 3 and platelet count below 1.5 lakh /mm 3 1 . However, criteria applied by “Kumar et al” were Hb less than 9 gm/dl, TLC less than 4000/mm 3 and platelet count below 1,40,000/mm 3 3 . Material and Methods To evaluate the cases of pancytopenia and to their causes this retrospective study was carried out in the department of Pathology. All the patients referred to hematology section of pathology department for routine hematological investigations and peripheral blood smear (PBS) examination, were screened for pancytopenia and a total number of 60 cases were selected based on the following all three criteria-  Hemoglobin less than 9 gm/dl  Total leucocyte count less than 4000/mm3 and  Platelet count less than 1,50,000/mm3 Patients who does not fulfill above criteria were excluded. Biochemical assays were not done. Detailed hematological investigations were done on the blood as follows: