骨髓活检术，儿科及成年人群全血细胞减少症的有效诊断方法。

Bone marrow biopsy, an effective diagnostic modality for pancytopenia among paediatric and adult population.

机构信息

Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan.

Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi,Pakistan.

出版信息

J Pak Med Assoc. 2022 Sep;72(9):1815-1819. doi: 10.47391/JPMA.2092.

DOI:10.47391/JPMA.2092

PMID:36280982

Abstract

OBJECTIVE

To determine the aetiologies of pancytopenia based on bone trephine biopsy among paediatric and adult patients.

METHOD

The retrospective cross-sectional study was conducted at the Haematology Department of Aga Khan University Hospital, Karachi, and comprised data from June 1, 2016, to October 31, 2019 related to pancytopenia patients who underwent bone marrow biopsy. Data included age, gender, presenting symptoms, physical examination, complete blood count, peripheral smear, bone marrow aspirate and trephine biopsy findings and final diagnosis. Data was analysed using SPSS 19.

RESULTS

Of the 2852bone marrow biopsies done, 255(9%) related to evaluation of pancytopenia. Of them, 208(82%) were adult and 47(18%) were paediatric patients. The median age for adults was 38.8 years (range: 16-92years) and that in paediatric patients was 10.9 years (range: 2-15 years). Presenting symptoms were available for 182(71.4%) patients, and the commonest symptom was generalised weakness 128(70.3%). Overall, pallor was the most frequent sign 233(93.2%). Anisocytosis was predominant blood smear finding 156(61.1%), while the commonest aetiology was aplastic anaemia in both paediatric 23(49%) and adult 57(27.4%) groups. Bone marrow biopsy established the diagnosis in 253(99.2%) cases, while 2(0.95%) adult cases were not diagnosed. Of the diagnosed cases, 103(40.4%) were malignant; 15(32%) paediatric patients and 88(42.3%) adults. The rest were benign; 31(67.4%) paediatric patients and 119(3%) adults.

CONCLUSIONS

Bone marrow biopsy helped in diagnosing all but 2 pancytopenic patients. Aplastic anaemia was the commonest cause in both paediatric and adult patients.

摘要

目的

通过儿童和成人患者的骨髓活检，确定全血细胞减少症的病因。

方法

本回顾性横断面研究于 2016 年 6 月 1 日至 2019 年 10 月 31 日在卡拉奇阿迦汗大学医院血液科进行，纳入了接受骨髓活检的全血细胞减少症患者的数据。数据包括年龄、性别、症状、体检、全血细胞计数、外周血涂片、骨髓抽吸和活检结果以及最终诊断。数据使用 SPSS 19 进行分析。

结果

在进行的 2852 例骨髓活检中，有 255 例（9%）与全血细胞减少症的评估有关。其中，208 例（82%）为成人，47 例（18%）为儿童患者。成人的中位年龄为 38.8 岁（范围：16-92 岁），儿科患者的中位年龄为 10.9 岁（范围：2-15 岁）。182 例（71.4%）患者有临床表现，最常见的症状是全身乏力 128 例（70.3%）。总体而言，苍白是最常见的体征 233 例（93.2%）。血涂片发现最常见的异形性 156 例（61.1%），而在儿科和成人两组中，最常见的病因均为再生障碍性贫血，分别为 23 例（49%）和 57 例（27.4%）。骨髓活检在 253 例（99.2%）病例中确立了诊断，而在 2 例（0.95%）成人病例中未明确诊断。在确诊病例中，103 例（40.4%）为恶性；15 例（32%）为儿科患者，88 例（42.3%）为成人。其余为良性；31 例（67.4%）为儿科患者，119 例（3%）为成人。