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Background: Pancytopenia is a serious and life threatening illness presented with multiple etiologies. The current study was done with the objective to evaluate the clinic-pathological factors responsible for incidence of pancytopenia in patients with vitamin B12 deficiency and their response to the therapy with vitamin B12.Methods: It was an observational study carried out at Department of Medicine, Mahatma Gandhi Memorial Government Hospital, Trichy, Tamilnadu during the period between December 2016 to December 2017. A total 50 patients with pancytopenia were clinically evaluated along with hematological parameters and bone marrow aspiration.Results: A total of 50 patients were included in the study. The mean age of the patients was 32.84 years with a male to female ratio of 1.5:1. All patients had history of fatigability. Commonest physical presentation was pallor (100%). Megaloblastic anaemia was the predominant blood picture in 58% patients. The common bone marrow finding was hyper cellular marrow with megaloblastic picture. Management with cyanocobalamin preparations and folate supplementations, significantly improved the reticulocyte count percentage in patients with pancytopenia (p=0.01)Conclusion: The study concluded that the most common cause of pancytopenia was megaloblastic anaemia. Detailed haematological investigations along with bone marrow aspiration in patients with cytopenia provided a clear understanding of disease process to identify the etiologies of pancytopenia.
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Objective To study the clinical significance of reticulocyte parameters change before and after chemotheraphy in acute leukemia.Methods Thirty-two chemotherapeutic patients suffered from acute leukemia were improved after chemotherapy.The percentage of reticulocyte(RET%),reticulocyte absolute value(RET#),low fluorescent reticulocyte percentage(LFR),middle fluorescent reticulocyte percentage(MRF),high fluorescent reticulocyte percentage(HFR),white blood cells(WBC) and absolute neutrophils count (ANC) and immature reticulocyte fraction(IRF) were detected by using the Sysmex 2000 automatic blood cell analyzer.Results IRF,MFR and HFR after chemotherapy in the patients with leukemia were always declined,reached the lowest on 7 d of chemotherapy,began to recover on 14 d after chemotherapy,and recovered to the level before chemotherapy on 21 d of chemotherapy.LFR began to increase on 7 d of chemotherapy,and began to decrease on 14 d of chemotherapy.WBC and RET# were always decreased on 7,14 d of chemotherapy,and began to recover on 21 d of chemotherapy.Conclusion IRF,MFR,HFR and LFR are the sensitive indicators reflecting the bone marrow recovery and are earlier than WBC and RET# by 7 d.