Spectrum of Diseases Diagnosed by Bone Marrow Examination in Central India

Abstract

BACKGROUND: Hematological diseases are quite frequent in population and mostly present with anemia. Although diagnosed mostly by clinical examination and simple investigations, bone marrow examination is confirmatory for the diagnosis. Bone marrow aspiration is simple and safe invasive procedure. Spectrum of hematological diseases in the developing countries is different from those observed in developed countries. OBJECTIVE: There is a lack of information about the exact relative prevalence of hematological disorders especially in Central India that's why this study was undertaken to correlate clinico-hematological and bone marrow findings. MATERIAL AND METHODS: It is a retrospective study of 345 cases who underwent bone marrow examination in Department Of Pathology, Gandhi Medical College, Bhopal. RESULTS: In our study age range of cases was 2-80 years with male: female ratio of 1.28:1. Most common diseases observed were megaloblastic anemia (41.81%), dimorphic anemia (16.72%), hypoplastic anemia (9.09%), ITP (8.36%) and infective pathology (4.72%). In Hematological malignancies (20.28%), most common were AML (6.95% of overall & 34.28% of malignant diseases %) followed by ALL (4.92 % overall and 24.28% % of malignancies). 3 cases of Gaucher's disease were also reported.96.81% patients were anemic while 44.92% were pancytopenic. Most common presenting symptoms were fever (44.92%) and bleeding manifestations (30.14%) which include ecchymosis, epistaxis, petechiae, melena, hematuria and hematemesis. Splenomegaly, hepatomegaly and lymphadenopathy were found in 35.65%, 21.15% and 14.78% of cases respectively. CONCLUSION: In our study final diagnosis could be made in majority of cases (92.76%) by bone marrow examination, although having varied clinical presentations such as fever, bleeding manifestations, ascites, hepatomegaly, splenomegalyetc and usually associated with anemia / pancytopenia/ thrombocytopenia.All hematological cases must undergo bone marrow examination to conclude the exact underlying pathology for appropriate treatment.