What is megaloblastic bone marrow?

Megaloblastic anemia is a condition in which the bone marrow produces unusually large, structurally abnormal, immature red blood cells (megaloblasts). Bone marrow, the soft spongy material found inside certain bones, produces the main blood cells of the body -red cells, white cells, and platelets.

Why is the bone marrow Hypercellular in megaloblastic anemia?

The impaired DNA synthesis in megaloblastic anemia slows nuclear replication and cell division and leads to ineffective erythropoiesis and premature destruction of the RBCs. Bone marrow sections and smears are hypercellular and reveal erythroid hyperplasia.

What is the confirmatory test for megaloblastic anemia?

Testing for megaloblastic anemia is often prompted by the identification of macrocytosis from a CBC; if neurologic symptoms or other clinical features prompt testing, a CBC should be performed. Hemoglobin and hematocrit can be measured to confirm anemia.

Does megaloblastic anemia cause Hypercellular bone marrow?

Macrocytosis associated with a megaloblastic marrow is usually accompanied by anemia due to ineffective erythropoiesis. The bone marrow is hypercellular, showing evidence of abnormal proliferation and maturation of multiple myeloid cell lines.

What kind of biopsy is megaloblastic anemia?

It is important to note that megaloblastic anemia is a morphologic diagnosis based on the cytologic and histologic features seen on the peripheral smear, bone marrow aspirate, and bone marrow core biopsy.

When to do bone marrow aspiration after megaloblastic anemia?

Of note, bone marrow megaloblastic changes are reversible within 12 hours after treatment with cobalamin or folate and bone marrow morphology appears to be normal within 2 – 3 days → bone marrow aspiration should be performed as soon as possible and preferably before treatment

Where to find megaloblasts in peripheral blood smear?

Large cells with an increased nuclear/cytoplasmic ratio with delayed nuclear maturation but more advanced cytoplasmic maturation Megaloblasts are usually abundant in bone marrow aspirates and can also be seen on peripheral blood smear

How long does it take for megaloblastic anemia to reversible?

Of note, bone marrow megaloblastic changes are reversible within 12 hours after treatment with cobalamin or folate and bone marrow morphology appears to be normal within 2 – 3 days → bone marrow aspiration should be performed as soon as possible and preferably before treatment.