Retrospective comparison of cytological and histological bone marrow morphology in adult antiretroviral-naïve and antiretroviral experienced human immunodeficiency virus-infected patients with peripheral blood cytopaenias

Figures & data

Table 1: Comparative of CD4 counts in ARV-naïve and ARV-experienced cohort

CD4 count (cells/uL)	ARV-naïve (%) (n = 24)	ARV-experienced (%) (n = 50)
<200	88 (21)	60 (30)
<100	50 (12)	21 (42)
<50	33 (8)	9 (18)
<10	17 (4)	5 (10)

Table 2: Frequency of cytopaenias in ARV-naïve and ARV-experienced cohort

Cytopaenia	ARV-naïve % (n = 24)	ARV-experienced% (n = 50)
Isolated anaemia	17 (4)	22 (11)
Isolated thrombocytopaenia	8 (2)	8 (4)
Isolated leucopaenia	4 (1)	0 (0)
Bicytopaenia	41 (10)	32 (16)
Pancytopaenia	29 (7)	38 (19)

Table 3: Comparison of median values in ARV-naïve and ARV-experienced cohort

Median	ARV-naïve (n = 24)	ARV-experienced (n = 50)
Age	32	32
M:F	1:1	1:2
CD4 (cells/ul)	90	126
Hb in anemia (g/dl)	8.0 (3.6–15.9)	7.9 (4.1–15.7)
WCC in leucopenia (X 10^9 cells/l)	4.65 (0.66–14.76)	3.77 (0.85–12.48)
Plts in thrombocytopenia (X10^9 cells/l)	60 (5–411)	104 (6–386)

Table 4: Comparative bone marrow morphology findings

	Not on ARV (%) (n = 24)	On ARV (%) (n = 50)
Cellularity
Normocellular	59 (14)	68 (34)
Hypocellular	12 (3)	20 (10)
Hypercellular	29 (7)	12 (6)
Dysplasia
Megakaryocytes	46 (11)	52 (26)
Erythroid	38 (9)	22 (11)
Myeloid	25 (6)	40 (20)
Architecture
Normal	50 (12)	40 (20)
Distorted	50 (12)	60 (30)
Presence of Granulomas in distorted BM	42 (10)	52 (26)
Presence of AFB in granulomas	60 (6)	35 (9)
Presence of a malignant infiltrate	4 (1)	4 (2)
Cause of cytopaenias
Inadequate haematopoiesis	17 (4)	38 (19)
Ineffective production	67 (16)	60 (30)
Increased peripheral destruction/sequestration	54 (13)	42 (21)
Bone marrow infiltration by infection	25 (6)	20 (10)
Bone marrow infiltration by neoplasia	4 (1)	4 (2)
Possible bone marrow infiltration	13 (3)	24 (12)
PRCA	4 (1)	14 (7)

Table 5: Duration on ARV and presence of dysplasia

Duration	% (n = 50)	Dysplasia (%)
<6 months	44 (22)	82
>6 months	34 (17)	52
Unknown	22 (11)	-

Figure 1: Ziehl Neelsen 100X magnification.

Note: Showing clumps of acid-fast bacilli.

Figure 2: Periodic-acid Schiff (PAS) 100X magnification.

Note: Showing PAS positive clumps of bacilli.