Abstract
Objectives: To determine the causes of pancytopenia, in patients presenting to a tertiary care hospital of Peshawar.
Subject and methods: This cross sectional study was conducted in the department of pathology, Hayatabad Medical Complex, Peshawar, from Sept 2007 to February 2009. A total of hundred patients with established diagnosis of the pancytopenia were selected through non-probability sampling techniques. Relevant information’s were obtained from the patients with the help of a predesigned questionnaire prepared in accordance with the objectives of the study.
Results: Out of 455 patients who underwent bone marrow biopsies, 100 patients were selected who were fulfilling the inclusion criteria. Sixty four patients were males and 36 females. The age range f the patients was from <1 year up to 70 years with mean age 18 ± 15.8years.
Seventy two percent of patients presented with most common features of anemia. About (45%) patients presented with symptoms related to neutropenia and 35% presented with bleeding disorders and (19%) with patiechiel spots. Regarding risk assessment 3 (3%) patients had used antipyretics, antimalarials and antibiotics for long times for various disorders. Out of total 78% patients had a poor financial status. Blood transfusion history was found in 80% patients. Mean hemoglobin with SD was 6.8+ 1.8. mean leukocytes count was mean was 2818.77/cmm with SD + 3746.97. Mean platelet count was 44040.0 with SD + 43318.86.Mean reticulocyte count of 1.76 with SD + 1.98.
Megaloblastic anemia contributed n=27 (27%) cases Out of total (18%) were ALL and 5 (05%) cases were AML. Aplastic anemia was recorded in (21%) cases. Fourth cause in descending order was hypersplenism 11% and visceral leishmaniasis was noted in 8%.

Conclusion: Pancytopenia is an important clinical problem, occurring more common in males. Megaloblastic anemia and malignant causes are major contributor to pancytpenia in our set up. Bone-marrow examination is an established diagnostic modality. The common causes of pancytopenia in our community, are completely curable while others can be treated to reduce morbidity and prolong survival.

Key words: Pancytopenia, Megaloblastic anaemia, Aplastic anaemia.