Correlation between Peripheral Blood Thrombocytopenia and Bone Marrow Findings – A Study of 100 Cases

ABSTRACT

Thrombocytopenia (platelet count less than 150,000/µl) is commonly encountered in routine hematological investigations. Here we present a study done to understand the prevalence of various conditions leading to thrombocytopenia, referred for bone marrow examination. It is a retrospective study done on 100 cases of thrombocytopenia referred for bone marrow examination in a tertiary care hospital from January 2016 to October 2016. The commonest cause of thrombocytopenia for which bone marrow was sought came out to be megaloblastic anemia followed by acute leukemia and aplastic anemia. Aim: Calculate the prevalence of various conditions causing thrombocytopenia, in cases referred for bone marrow examination, and Understand the various megakaryocytic alterations in hematological disorders presenting with thrombocytopenia due to different mechanisms. Methods: A retrospective study was done on 100 patients of thrombocytopenia referred for bone-marrow aspiration in a tertiary care hospital catering to both rural and urban population from January 2016 to October 2016. All cases of thrombocytopenia (platelet count less than 1,50,000/µl) diagnosed on hematology analyzer and later confirmed by peripheral blood film examination, referred for bone marrow examination for various reasons were included in this study. Stained bone-marrow aspirate smears were examined. Records regarding the clinical indication for the procedure, peripheral blood smear reports, blood counts and significant findings on bone-marrow aspiration smears were retrieved. The role of bone-marrow aspiration in the diagnosis of hematological and non- hematological disorders was reviewed in the study. Results: The commonest cause of thrombocytopenia for which bone marrow examination was sought was megaloblastic anemia(76%), followed by acute leukemia(7%), aplastic anemia(5%), myelodysplastic syndrome (4%) which was followed by ITP(3%), and one case each of gelatinous marrow transformation, malaria and NHL spillover. Conclusion: Further studies on the evaluation of megakaryocytic alteration and their contribution to thrombocytopenia can provide growing knowledge to the pathogenesis of numerous hematopoietic disorders that may identify broader clinical applications of the newer strategies to regulate platelet count and functioning.