Pancytopenia--a six year study.

All cases of pancytopenia seen over a six year period in two hematology centres were analysed. Patients receiving myelotoxic chemotherapy or those with leukemic cells in peripheral smear were excluded. There were a total of 166 cases. The four major causes were: aplastic anaemia in 49, megaloblastic anaemia in 37, aleukemic leukemia or lymphoma in 30 and hypersplenism in 19 cases. Bone marrow aspiration was often unsuccessful in obtaining an adequate sample, while biopsy was usually diagnostic. Both bone marrow aspiration and biopsy should be performed simultaneously in pancytopenic patients when the diagnosis is elusive. Megaloblastic anaemia is a major cause of pancytopenia, and may present acutely in the critically ill. It is a rapidly correctable disorder and should not be missed.