A study to see alterations in morphology of megakaryocytes in bone marrow aspiration in cases of thrombocytopenia.

Abstract: The term thrombocytopenia is used when the platelet count is less than 150,000/microliter. It can be encountered in various hematological disorders i.e non-myelodysplastic hematological conditions to myelodysplastic syndrome. Aim: The present study was undertaken to calculate the prevalence of various conditions that are associated with thrombocytopenia and to see the alterations in megakaryocytes morphology in bone marrow in various cases of thrombocytopenia. Methods: This study was a prospective series of 63 bone marrow aspiration conducted in Bir Hospital, NAMS in patients who presented with thrombocytopenia. Statistical Analysis: The distribution of various morphological changes in cases on non-myelodysplastic conditions and myelodysplastic syndrome were compared using Chi-square test. A p-value less than 0.05 was considered significant. Results: In the present study, the commonest cause for thrombocytopenia for which bone marrow examination was sought was megaloblastic anemia, followed by acute leukemia and mixed maturation. In non-myelodysplastic condition such as immune thrombocytopenia showed immature megakaryocytes, bare megakaryocytes, emperipolesis and cytoplasmic vacuolations in the megakaryocytes. Similar morphological features was observed in myelodysplastic syndrome as well. Conclusion: Further studies on the evaluation of megakaryocytic alteration and their contribution to thrombocytopenia can provide growing knowledge to the pathogenesis of numerous hematopoietic disorders that may identify broader clinical applications of the newer strategies to regulate platelet count and functioning.