Clinicopathological Spectrum of Pancytopenia in Adults Without Known Malignancy at a Tertiary Care Hospital in Central India

BackgroundPancytopenia has diverse nutritional, infectious, systemic, and marrow-related causes.Its etiological distribution depends on the population evaluated and the diagnostic setting.The primary objective was to describe diagnostic categories among adults with pancytopenia without known malignancy.Secondary objectives were to characterize clinical, hematological, and marrow findings and explore differences in selected characteristics across diagnostic groups. Materials and methodsThis prospective observational study included 162 consecutively enrolled adults over 18 months.Pancytopenia was defined as hemoglobin <13 g/dL in men or <12 g/dL in women, leukocyte count <4,000/µL, and platelet count <150,000/µL.Patients with known malignancy or previous or current chemotherapy or radiotherapy were excluded.Clinical assessment, complete blood counts, peripheral smears, and clinically indicated investigations were evaluated.Bone marrow aspiration was performed when indicated.Categorical associations were assessed using chi-square or Fisher-Freeman-Halton exact tests. ResultsThe mean age was 39.71 ± 13.40 years; 93 patients (57.4%) were men.Generalized weakness occurred in 147 patients (90.7%) and pallor in 160 (98.8%).Mean hemoglobin was 6.87 ± 1.62 g/dL.Nutritional deficiency accounted for 77 cases (47.5%), hypersplenism for 51 (31.5%), and infectious or immune-mediated systemic disorders for 34 (21.0%).Megaloblastic anemia was the most frequent individual diagnosis (62; 38.3%).Bone marrow aspiration was performed in 147 patients (90.7%); 101 aspirates (68.7%) were hypercellular, and 58 (39.5%) showed megaloblastic erythropoiesis.Age category was associated with etiological group (p = 0.017), whereas sex was not (p = 0.592). ConclusionsNutritional deficiency, particularly megaloblastic anemia, and hypersplenism were the most frequent diagnostic categories in this selected adult cohort.Hypercellularity was the predominant marrow cellularity pattern, and megaloblastic erythropoiesis was the most frequent morphological finding among aspirated patients.