Evaluation of pancytopenia based on bone marrow examination in adults in a tertiary care hospital in Islamabad.


  • Maryam Zulfiqar HBS Medical and Dental College Islamabad.
  • Bushra Anam Ali Fazaia Medical College Islamabad.
  • Shahzad Ali Jiskani SMBB Medical University Larkana.
  • Maryam Waqar HBS Medical & Dental College.
  • Maliha Saad HBS Medical & Dental College.
  • Humera Javed HBS Medical & Dental College.




Bone Marrow Aspiration, Infections, Megaloblastic Anemia, Pancytopenia


Objective: To evaluate etiological spectrum of pancytopenia in adults using bone marrow aspiration biopsy. Study Design: Randomized Prospective study. Setting: Department of Pathology, Pakistan Institute of Medical Sciences, Islamabad. Period: October 2018-October 2020. Material & Methods: Eight hundred bone marrow biopsies were performed out of which 250 patients came with pancytopenia. 135 patients out of these were in adult age group which are included in this study. Results: Out of 250 patients adults were 135 that presented with pancytopenia. Male to female ratio came out to be 1.22:1. The most common disorder that results in pancytopenia came out to be megaloblastic anemia that was 29.6%, after that 26.6% were infection related changes, 10.3% aplasia, 9.6% reactive marrow, 5.9% acute leukemia, 3.7% chronic leukemia and iron deficiency anemia followed by 2.9% myelodysplastic syndromes and hypersplenism, 2.2% multiple myeloma, 1.4% mixed deficiency anemia and 0.74% myelofibrosis. We also analyzed patients on their presenting complaints as well. Most common complaint of presentation was fever (54.8%), (31.85%) with fatigue and malaise, (31.1%) pallor, vomiting and diarrhea (25.9%) followed by bleeding (14.8%). On clinical examination 12% cases presented with hepatomegaly and 16.6% with splenomegaly. Conclusion: Pancytopenia is a common hematological finding in our setup with megaloblastic anemia to be the most common cause of it. Therefore, it’s very important to diagnose it as this is a curable (reversible) deficiency and patients can easily be managed to prevent serious hematological and neurological abnormalities.

Author Biographies

Maryam Zulfiqar, HBS Medical and Dental College Islamabad.

MBBS, M.Phil (Hematology), Senior Lecturer Pathology, 

Bushra Anam Ali, Fazaia Medical College Islamabad.

MBBS, M.Phil (Hematology), Demonstrator Pathology, 

Shahzad Ali Jiskani, SMBB Medical University Larkana.

MBBS, M.Phil (Hematology), Assistant Professor Pathology, 

Maryam Waqar, HBS Medical & Dental College.

MBBS, M.Phil (Histopathology), DCP, Assistant Professor Pathology, 

Maliha Saad, HBS Medical & Dental College.

MBBS, FCPS (Hematology), Assistant Professor Pathology, 

Humera Javed, HBS Medical & Dental College.

MBBS, MCPS (Pathology), Assistant Professor Chemical Pathology,