An observational study of the clinicopathological presentation of aplastic anemia in a tertiary hospital

Abstract

Introduction: Pancytopenia in the peripheral smear and hypocellularity in the bone marrow characterise aplastic anaemia (AA). It is far less common in Western countries. The Asian continent has a greater prevalence rate. Aplastic anemia carries a high mortality rate if it is not treated. Hence early diagnosis and treatment is important to reduce the mortality rate. Only few Indian studies are conducted to assess the epidemiology of AA. Aims and Objectives: To evaluate clinical and pathological profile of patients with aplastic anemia. Materials and Methods: This cross sectional observational study was done over a period of 1.5years in department of medicine, St johns medical college, Bangalore. A detailed clinical history, physical examination and available previous investigations were recorded. Results: In our study aplastic anemia had bimodal peak in age distribution noted in groups of 21-30 & 51-60yrs .Male preponderance of 1.33:1 .Most common presenting complaint was Fatigue. Severe (37.6%) and Very severe aplastic anemia (37.6%) were more common.Most common 1st line agent was Cyclosporine and 2nd line agent was Danazol. Out the 35 only 4 (11.4%) showed Complete Response, 19 (54.3%) showed Partial Remission, 10 were transfusion dependent (28.6%) and 2 (5.8%) expired. Conclusion: ATG and Cyclosporine showed significant improvement in most parameters. Many patients in the study were unwilling for ATG and bone marrow transplantation due to the cost factor. Many are still requiring frequent transfusions, thus probing us to search for newer novel forms of treatment to reduce the cost of treatment and mortality in aplastic anemia patients.

Keywords

• pancytopenia
• severity
• clinical profile
• aplastic anemia