Aplastic anemia laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.D. [2] Nazia Fuad M.D.

Overview

Patients with aplastic anemia have a hypoplastic bone marrow (<20% cellularity), pancytopenia (transfusion-dependent anemia, thrombocytopenia, and severe neutropenia), a low reticulocyte count, and a normal maturation of all cell lines.

Laboratory Findings

Laboratory findings consistent with the diagnosis of aplastic anemia include:

Complete Blood Count (CBC)

• Decreased hemoglobin
• Decreased hematocrit
• Pancytopenia (anemia, thrombocytopenia, and severe neutropenia)

Reticulocyte Count

• Reticulocytopenia.

Peripheral blood smear

• Macrocytosis
• Poikilocytosis
• Small size platelets

Other tests

The following tests should be performed to rule out other conditions:

• Renal function
• Basic metabolic panel
• Liver enzymes
• Thyroid function tests
• Viral studies
• Vitamin B12 and folic acid levels.

Definitive Diagnosis

Bone Marrow Aspiration and Biopsy

• Hypocellular bone marrow with increased adipose tissue and decreased hematopoietic cells in the marrow space
• Bone marrow biopsy shows normal maturation of all cell lines.