Spectrum of bone marrow aspirations and their clinico-hematological profile in children

Abstract

Background: Objective of current study was to study the spectrum of bone marrow aspiration results and their clinico-hematological profile in children. Methods: Design: Cross sectional descriptive study, conducted from 1st April 2011 to 31st March 2012. Setting: Referral care centre in Northern India. Participants: All hospitalized patients in the age group of 0-18 years requiring a bone marrow examination for various hematological disorders. Procedure: A total of 140 children underwent bone marrow examination during the study period. An aspirate smear was prepared and stained with Romanowsky’s stain, Prussian blue stain was used for staining iron. Demography, history, examination and the investigations of patients who underwent bone marrow aspiration were noted in a preset proforma. Results: The most common hematological disorder encountered was Iron deficiency anemia accounting for 41.43% of all cases. Idiopathic thrombocytopenic purpura was the most common platelet disorder (12.85%). Acute lymphoblastic leukemia was the commonest hematological malignancy diagnosed (6.42%), followed by acute myeloblastic leukemia (4.28%), visceral leishmaniasis (1.43%), malaria (0.71%), lymphohistiocytosis (0.71%) and anemia of chronic disorder (0.71%). Conclusions: The most common condition encountered on bone marrow examination during our study was iron deficiency anemia. In absence of relevant etiological investigations in resource poor settings bone marrow aspiration is done in severe anemia to confirm nutritional deficiency anemia or to rule out hematological malignancies. The threshold of doing bone marrow was also low in patients of ITP as one contemplated putting a patient on steroids.