Bone Marrow Examination in Cases of New-onset Pancytopenia: A Four-year Study from a Medical College in the Rural Hilly Setting of Western Himalayas, India

New-onset pancytopenia is a common diagnostic challenge. Pancytopenia is an indication for bone marrow examination. The present study has been carried out to determine the frequencies of various etiologies of pancytopenia based on bone marrow morphology in a defined geographical location. All cases of new-onset pancytopenia, diagnosed on peripheral smear and seen over a four-year period from January 2012 to December 2015 in the department of pathology, were analysed. Patients lacking representative bone marrow in the aspirate or receiving chemotherapy were excluded. Out of 69 cases, 29 were males and 40 were females. Most of the patients were in the age group of 19-60 years (52.2%). Nineteen (26.1%) of them were less than 18 years old. The three major causes of pancytopenia were: megaloblastic anemia (hypercellular marrow with megaloblastic erythropoiesis) in 25 (36.2%) cases, hypercellular marrow with dimorphic erythropoiesis in 13 (18.8%) cases, and haematological malignancies in 12 (17.4%) cases of the study. Bone marrow examination along with laboratory evaluation helps to establish specific diagnosis in cases of new-onset pancytopenia.