Background: The bone marrow examination is being admitted as an essential diagnostic tool for various hematologic and non-hematologic disease, especially the evaluation of a peripheral pancytopenia or bicytopenia. However, in only anemia or bicytopenia, there seems to be an avoiding or reluctant tendency of performing the bone marrow examination due to the prevailing idea of somewhat invasiveness. So we were intended to evaluate the importance of the bone marrow examination as a diagnostic tool in anemia, bicytopenia and pancytopenia.
Methods: We reviewed 387 cases of cytopenia among the total 590 cases which had been performed the bone marrow examinations at the clinical pathology department of
Ewha Womans University Hospital for the past five years(1987-l991). And we classified the cytopenia into four groups, the cases with only anemia (group I), those with both anemia and thrombocytopenia(group II), those with both anemia and leukopenia(group III), and those with pancytopenia(group IV), and analyzed their characteristics.
Results:
1. The group I was 161 cases(41.6%), group II 114 cases(11.4%), group III 44 cases(11.4%), and group IV 68 cases(17.6%).
2. The malignancy rate of the group II(64.0%) or group III(54.5%) was significantly higher than that of the group I(21.1%) or group IV(32.4%)(p<0.05, respectively).
3. The most common cause of malignancy was non-hematopoietic malignancy(6.2%) in group I, AML in group II(24.5%) and III(25.0%), and MDS(19.2%) in group IV.
4. Hypercellular marrow was common in group I and II, and hypocellular marrow was common in group IV.
Conclusion: We suggest that in the condition of bicytopenia such as the anemia and thrombocytopenia or the anemia and leukopenia, the indication of the bone marrow
examination should be mandatory for the possibility of the malignancy.

Keywords: Bone marrow, Anemia, Thrombocytopenia, Leukopenia, Malignancy