A study of absolute reticulocyte counts in patients with pancytopenia

Abstract

Pancytopenia is a common hematological condition with diverse etiologies, ranging from bone marrow suppression to peripheral destruction. Bone marrow examination is the gold standard for diagnosing the underlying cause; however, it is invasive and resource-intensive. Reticulocyte indices, including absolute reticulocyte count (ARC), play a pivotal role in assessing marrow erythropoietic activity. The aim of the study was to find the significance of absolute reticulocyte count as a surrogate marker for bone marrow examination in patients with pancytopenia. This was a prospective observational study of 126 patients ≥ 18 years of age with pancytopenia - Hb <9g/dL, WBC count <4000/µL and platelets less than 1,00,000/µL, admitted in our hospital from 1st July, 2023 to 31st October 2024. Patient’s characteristics like age, sex, hematological parameters like Hb, RBC count, WBC count, Platelet count, MCV, RDW, LDH, Reticulocyte count, ARC were analyzed. Majority of the patients belonged to the age group 40 to 65. Mean age of the population was 52.47(±16.26). Female preponderance was noted in our study. Aplastic anemia was the commonest cause of pancytopenia in our population followed by Myelo Dysplastic Syndrome(MDS) and megaloblastic anemia. High mean ARC(ARC≥100×109/L) was noted in patients with hypersplenism and acute leukemia. Normal mean ARC(50-99.99×109/L) was noted in patients with SLE and disseminated TB. Very low mean ARC (<25×109/L) was noted in patients with aplastic anemia, hypoplastic MDS and drug induced pancytopenia. Low mean ARC (25- 49.99×109/L) was noted in patients with megaloblastic anemia, dual deficiency and MDS.