Clinical Characteristics Of 271 Cases Of Pancytopenia

Objective: To explore the etiology of pancytopenia(PCP)and the characteristics of clinical and laboratory related indexes of different etiologies,so as to provide differential diagnosis ideas for clinical practice,improve the efficiency of disease diagnosis,and avoid misdiagnosis or missed diagnosis.Methods: The clinical data of 271 patients with pancytopenia were analyzed retrospectively.Results: 1.271 patients with pancytopenia were 14-97 years old and the median age was 64 years old.There were 125 males and 146 females.Among 271 patients,236(87.08%)were diagnosed with hematological diseases,the top four diseases were megaloblastic anemia(MA,75,27.68%),aplastic anemia(AA,49,18.08%),acute leukemia(AL,47,17.34%),myelodysplastic syndrome(MDS,34,12.55%).35 cases(12.92%)were diagnosed with non-hematological diseases,the most common kind of which was liver disease(19 cases,7.01%),followed by malignant tumor(7 cases,2.58%),connective tissue disease(5 cases,1.85%).3.AA was predominant in young PCP patients,Followed by MA and AL(Acute promyelocytic leukemia was predominant in AL),MA was the most common diseases in elderly PCP patients,Followed by AL(The most of which was acute monocytic leukemia)and MDS.The proportion of bone marrow blasts was higher in elderly patients than that in younger patients.4.The comparison of peripheral blood cell parameters showed that MCV,MPV,RDW and PDW were higher in MA and MDS patients than that in other diseases.5.The level of Ferritin and serum vitamin B12 were generally increased in newly diagnosed AL,but was highest in APL.Folate was decreased in newly diagnosed AL,especially in APL and ALL.6.Serum CA153 level was increased significantly in MA patients,and there was a positive correlation between CA153 and LDH.Meanwhile,CA153 level was increased with the decrease of that of Vit B12.Conclusion: The common causes of PCP in this study were MA,AA,AL,MDS and liver disease.The increase of MCV,MPV,RDW and PDW is significant in the differentiation of MA and MDS.The increase of Serum ferritin,Vit B12 and the decrease of FA were significant in the differentiation of AL and other diseases.The increase of CA153 in MA has differential diagnostic significance.