Asian Oncology Research Journal

Background: Peripheral cytopenias, including anemia, thrombocytopenia, bicytopenia, and pancytopenia, are common findings in patients with hematological malignancies (HMs) and often necessitate bone marrow evaluation for definitive diagnosis. This study aimed to determine the spectrum of HMs and their association with various patterns of peripheral cytopenia at a major oncology center in Aden, Yemen.

Methods: This descriptive, retrospective study included 70 patients diagnosed with HMs at the Hematology Department of the National Oncology Center, Aden, between January 2019 and December 2020. All patients underwent comprehensive assessment including history, physical examination, full blood count, and bone marrow aspiration/biopsy. Data were analyzed using SPSS version 26, with a p-value < 0.05 considered statistically significant.

Results: Peripheral cytopenia was present in 84.3% (n=59) of HM patients. The median age was 50 years, with a male-to-female ratio of 1.5:1. Bicytopenia was the most common pattern (52.5%), followed by isolated anemia (27.1%), pancytopenia (10.2%), and isolated thrombocytopenia (10.2%). Acute leukemias constituted 61.0% of cases among cytopenic patients, with Acute Lymphoblastic Leukemia (ALL) and Acute Myeloid Leukemia (AML) being the most frequent subtypes. A significant association was found between AML and both pancytopenia (83.3% of pancytopenic cases) and isolated thrombocytopenia (50.0% of isolated thrombocytopenic cases) (p<0.05). Conversely, Multiple Myeloma (MM) was significantly associated with normal peripheral blood counts (36.4% of non-cytopenic cases) (p<0.05). Bone marrow   examination in cytopenic patients frequently revealed hypercellularity, decreased erythrocyte precursors, and decreased megakaryocytes, indicative of ineffective hematopoiesis and marrow infiltration.

Conclusion: Peripheral cytopenia is highly prevalent among HM patients in Aden, with bicytopenia being the dominant pattern. The strong association between acute leukemias and severe cytopenias underscores the aggressive nature and advanced presentation of these malignancies in this population. These findings are crucial for guiding diagnostic strategies and clinical management in resource-limited settings and emphasize the importance of prompt bone marrow examination in patients with unexplained multi-lineage cytopenia.