The myelodysplastic syndrome(s): a perspective and review highlighting current controversies

Pancytopenia in Zimbabwe

Epidemiology of Aplastic Anemia in France: A Prospective Multicentric Study

Background: The etiology of bicytopenia/pancytopenia varies widely in children, ranging from transient marrow viral suppression to marrow infiltration by fatal malignancy. Depending on the etiology, the clinical presentation can be with fever, pallor or infection. Knowing the exact etiology is important for specific treatment and prognostication. Aims: To evaluate the etiological and clinico-hematological profile in children with bicytopenia and pancytopenia. Materials and Methods: A review of bicytopenic and pancytopenic children referred for bone marrow examination from January 2007 to December 2008 was done. Detailed history, clinical examination and hematological parameters at presentation were recorded. Results and Conclusion: During the study period, a total of 990 children were referred for bone marrow examination for different indications. Of these, 571 (57.7%) had either pancytopenia (17.7%) or bicytopenia (40%). Commonest form of bicytopenia was anemia and thrombocytopenia seen in 77.5% cases, followed by anemia and leukopenia in 17.3% and leukopenia and thrombocytopenia in 5.5% cases. Most common etiology was acute leukemia (66.9%) in bicytopenic children and aplastic anemia (33.8%) in pancytopenic children. Children with bicytopenia had a higher incidence of underlying malignancy (69.5% vs. 26.6%), splenomegaly (60.5% vs. 37.4%), lymphadenopathy (41.8% vs. 15.1%) and circulating blasts (64.6% vs. 20.1%) and a lower incidence of bleeding manifestations (12.1% vs. 26.6%) as compared to children with pancytopenia.

Pediatric patients with bicytopenia/pancytopenia: Review of etiologies and clinico-hematological profile at a tertiary center

Objective:�Theobjectiveofthisstudywastodeterminethefrequencyofcommoncausesleadingto� Pancytopenia in patients presenting to tertiary care hospital at Karachi. Methods:�Atotalof�62�patientswiththediagnosisofPancytopeniaofmorethanoneweekdurationwere� enrolledinthestudy.�Allpatientsunderwentadetailedmedicalhistoryandfullphysicalexamination� followedbybloodsamplingfortheinvestigationsi.e.�completebloodcountwithperipheralfilm,�erythrocyte� sedimentation rate (ESR), Malarial parasites (MP), liver function test, Renal function tests, PT and viral profile� (HBsAg,�Anti-HCV),�Ultrasonographyofabdomen.�Allpatientsunderwentbonemarrowaspiration� andtrephinebiopsyforreportingandinterpretation.�Durationofstudywassixmonths,�fromMay�2010�to� November 2010. Results: The average age of the patients was 37.76 ± 16.38years. Out of 62 patients, 36 (58%) were male and 26 (42%) were female. Megaloblastic anemia was the commonest cause that was observed in 41.9% cases followed by acute myeloid leukemia 27.4%, aplastic anemia 19.4% and erythroid hyperplasia 11.3%. Conclusion: This study concluded that most common cause of pancytopenia is Megaloblastic anemia, followedbyacutemyeloidleukemiaandaplasticanemia.�Bonemarrowexaminationisasingleuseful� investigation which reveals the underlying cause in patients with pancytopenia.

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The common causes leading to pancytopenia in patients presenting to tertiary care hospital

We reviewed 213 consecutive adult pancytopenic patients to determine the frequency of underlying pathology, to analyze our diagnostic procedure, and to determine the value of peripheral blood data for diagnosis. Pancytopenia was defined as the association of hemoglobin level below 12 g/dl in males and 11.5 g/dl in females, leukopenia below 4 x 10(9)/L, and thrombocytopenia below 150 x 10(9)/L. The bone marrow aspirates were normo- or hypercellular in 140 cases (66%). Bone marrow biopsies, performed in 93 cases, documented the presence of myelofibrosis in 67 cases. Aplastic anemia was diagnosed in 10% of the cases. Malignant myeloid disorders (acute myeloid leukemias, myelodysplastic syndromes, acute myeloid disorders with myelofibrosis) represented 42% of the cases and various malignant lymphoid disorders 18%. Vitamin deficiencies accounted for 7.5% and nonhematological pathology 10% of the cases. The bone marrow aspirate was sufficient for the diagnosis in 55% of the cases, and the trephine biopsy was necessary in 30%. In the remaining cases, other complementary tests were necessary to achieve final diagnosis. A discriminant analysis, focused on the hemogram data, showed that parameters obtained by analysis of blood smears were helpful for the diagnosis, especially the presence or absence of blast cells and/or of abnormal lymphoid cells.

Adult patients presenting with pancytopenia: a reappraisal of underlying pathology and diagnostic procedures in 213 cases.

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Adult patients presenting with pancytopenia: a reappraisal of underlying pathology and diagnostic procedures in 213 cases.