Histomorphology of bone marrow from adult pancytopenic patients at the University teaching hospital in Lusaka, Zambia.

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Musonda, Francis Kaoma
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The University of Zambia.
Pancytopenia is a hematologic condition characterised by leukopenia, anaemia and thrombocytopenia. Pancytopenia is not a diagnosis and has to be qualified by determination of its cause. The aetiologies of pancytopenia are diverse, and study of bone marrow cytology and histology are key components that assist in the determination of the underlying cause. Pancytopenia is encountered regularly in medical practice in Zambia; however, no studies have been conducted on pancytopenia to date. A total of 45 bone marrow biopsies were collected over the study period. In all cases the indication was pancytopenia that had been confirmed by a full blood count done at the UTH and the biopsy site was either the anterior superior iliac spine or the posterior superior iliac spine. Demographic and clinical details were obtained using data collection sheets and from review of patient records. The collected data was analysed using the Statistical Package for the Social Sciences (SPSS) version 21 and excel 2016 data analysis tool pack. A Chi square test was used to measure association between categorical variables and Student’s t-test to measure association between categorical and numerical values. A p value of < 0.05 at 95% confidence interval was considered statistically significant. There were 32 females (71%) and 13 males (29%), and the age ranged from 15 to 72 years with an average age of 35 years. Forty percent (n=18) of the study participants had human immunodeficiency virus (HIV) and all of these all were on highly active antiretroviral therapy (HAART). There were 6 histologic patterns found the commonest being megaloblastosis seen in 38% of the patients, followed by malignancy and myelodysplasia both at 17.0%. Bone marrow aplasia accounted for 13.0%, non-megaloblastic erythroid hyperplasia accounted for nine percent and myelofibrosis for four percent. The bone marrow biopsies of the study population showed six histomorphologic pictures which in order of frequency were megaloblastosis, malignancy and myelodysplasia, bone marrow hypoplasia, non-megaloblastic erythroid hyperplasia and myelofibrosis.
Thesis of Master of Medicine in Pathology.