PATHOPHYSIOLOGY OF PANCYTOPENIA: UNDERSTANDING BLOOD CELL PRODUCTION AND REGULATION IN THE BONE MARROW
DOI:
https://doi.org/10.22159/ijcpr.2023v15i4.3029Keywords:
Pancytopenia, Bone marrow, Peripheral bloodAbstract
Objective: The bone marrow is the primary site for blood cell formation, responsible for the production and export of red cells, platelets, and granulocytes. Pancytopenia is a condition characterized by a reduction in all three types of cellular components in peripheral blood, leading to symptoms of marrow failure. The management and prognosis of pancytopenia depend on identifying the underlying pathology.
Methods: The pathophysiology of pancytopenia involves various factors such as infections, toxins, malignant cell infiltration, suppression, or ineffective hematopoiesis. Bone marrow examination, including aspiration and trephine biopsy, is crucial for diagnosing pancytopenia, especially when the cause is unclear or when malignancy is suspected. Geographic distribution and genetic disturbances contribute to variations in the incidence of disorders causing pancytopenia.
Results: The study aims to evaluate the various causes of pancytopenia and correlate peripheral blood findings with bone marrow aspirate and trephine biopsy. The collected data will assist in planning the diagnostic and therapeutic approach for patients with pancytopenia.
Conclusion: Pancytopenia involves disruptions in blood cell production and regulation. Bone marrow aspiration and trephine biopsy are crucial for diagnosis. Understanding blood cell regulation provides insights. This study aims to enhance diagnostic and therapeutic approaches for pancytopenia.
Downloads
References
Young NS. Aplastic anemia. N Engl J Med. 2018;379(17):1643-56. doi: 10.1056/NEJMra1413485, PMID 30354958.
Marsh JCW, Ball SE, Darbyshire P, Gordon Smith EC, Keidan AJ, Martin A. Guidelines for the diagnosis and management of acquired aplastic anaemia. Br J Haematol. 2003;123(5):782-801. doi: 10.1046/j.1365-2141.2003.04721.x.
DeZern AE, Brodsky RA. Clinical management of paroxysmal nocturnal hemoglobinuria. Hematol Oncol Clin North Am. 2018;32(4):627-41.
Wood BL, Michaels MA, Dores GM. Paroxysmal nocturnal hemoglobinuria and secondary myelodysplastic syndrome: a case-control study. Leuk Res Treat. 2012;2012:1-6.
Gimeno E, Salido M, Sole F, Florensa L, Granada I, Domingo A. CD5 negative and CD5 positive splenic marginal B-cell lymphomas have differential cytogenetic patterns. Leuk Res. 2005;29(8):981-2. doi: 10.1016/j.leukres.2005.02.001. PMID 15978952.
Bowen D, Culligan D, Jowitt S, Kelsey SM, Mufti GJ, Oscier DG. Guidelines for the diagnosis and therapy of adult myelodysplastic syndromes. Br J Haematol. 2003;120(2):187-200. doi: 10.1046/j.1365-2141.2003.03907.x, PMID 12542475.
Rawstron AC, Green MJ, Kuzmicki A, Kennedy B, Fenton JAL, Evans PAS. Monoclonal B lymphocytes with the characteristics of ”indolent” chronic lymphocytic leukemia are present in 3.5% of adults with normal blood counts. Blood. 2003;101(2):504-10.
Vannucchi AM, Guglielmelli P, Tefferi A. Advances in understanding and management of myeloproliferative neoplasms. CA Cancer J Clin. 2009;59(3):171-91. doi: 10.3322/caac.20009. PMID 19369682.
Arber DA, Orazi A, Hasserjian R, Thiele J, Borowitz MJ, Le Beau MM. The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia. Blood. 2016;127(20):2391-405. doi: 10.1182/blood-2016-03-643544, PMID 27069254.
Yu L, Li L, Medeiros LJ, Young KH. NF-κB signaling pathway and its potential as a target for therapy in lymphoid neoplasms. Blood Rev. 2017;31(2):77-92. doi: 10.1016/j.blre.2016.10.001. PMID 27773462.
Witte ON, Kilic SS. Disorders of granulopoiesis and monopoiesis: recent advances. Blood. 2011;118(25):6550-4.
Dameshek W. Hypoplastic and aplastic anemias: differentiation by means of bone marrow cultures. J Am Med Assoc. 1951;147(6):449-54.
Tilak V, Jain R. Pancytopenia-a clinico-hematologic analysis of 77 cases. Indian J Pathol Microbiol. 1999 Apr;42(4):399-404. PMID 11127368.
Ali S, Ullah F, Ullah H. Effects of intensity and duration of exercise on total leukocyte count in normal subjects. J Ayub Med Coll Abbottabad. 2002;14(3):16-8. PMID 12476857.
Dodhy MA, Baloch QH, Ahmed SM, Ahmed SM, Baloch RA, Memon FN. Clinico-hematological analysis of pancytopenia: a single center study of 164 cases. Int J Pathol. 2005;3(2):65-9.
Rahim F, Khan AH, Khan AA. Etiological spectrum of pancytopenia based on bone marrow examination in patients presenting at Liaquat University Hospital, Hyderabad. J Liaquat Univ Med Health Sci. 2005;4(1):4-7.
Prichard NC. Beta-adrenoceptor blocking drugs and their use in hypertension. S Afr Med J. 1976;50(47):1902-9. PMID 12577.
Verma N, Dash S. Aplastic anaemia as a cause of pancytopenia-an experience in a tertiary care set up. Indian J Pathol Microbiol. 1992 Apr;35(2):117-20.
Khodke K, Marwah S, Buxi G, Saxena R. Pancytopenia-a clinico-hematologic analysis of 77 cases. Indian J Pathol Microbiol. 2002 Oct;45(4):427-9.
Kumar R, Kalra SP, Kumar H, Anand AC, Madan H. Pancytopenia-a six year study. J Assoc Physicians India. 2001 Jul;49:1078-81. PMID 11868860.
Jha A, Sayami G, Adhikari RC, Panta AD, Jha R. Bone marrow examination in cases of pancytopenia. JNMA J Nepal Med Assoc. 2008 Apr-Jun;47(169):12-7. doi: 10.31729/jnma.209, PMID 18552886.
Imbert M, Scoazec JY, Mary JY, Jouzult H, Rochant H, Sultan C. Adult fanconi’s syndrome associated with primary hypogonadism and malignant melanoma: study of a new case and review of the literature. Am J Med. 1989 Sep;87(3):331-40.
Greenberg PL, Tuechler H, Schanz J, Sanz G, Garcia Manero G, Sole F. Standardization of response criteria, treatment outcomes, and reporting standards for therapeutic trials in myelodysplastic syndromes. Revised international prognostic scoring system for myelodysplastic syndromes. Blood. 2012 Dec 20;120(26):2454-65.
Published
How to Cite
Issue
Section
Copyright (c) 2023 ANUJ SHARMA, VIJETA TOMAR, NAMRATA AGARWAL, SUDHAKAR SHARMA
This work is licensed under a Creative Commons Attribution 4.0 International License.