{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T21:52:14Z","timestamp":1794001934708,"version":"4.8.0"},"reference-count":20,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Frontline Gastroenterol"],"accepted":{"date-parts":[[2020,1,21]]},"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n                  <jats:title>Background and aim<\/jats:title>\n                  <jats:p>Peripheral cytopaenias and dyspoiesis are common in cirrhosis; however, the prevalence of dyspoiesis and its contribution in cirrhosis-related cytopaenias has not been studied. We aimed to study the bone marrow (BM) dyspoiesis and its impact on peripheral blood cell counts and refractory anaemia in patients with cirrhosis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Patients and methods<\/jats:title>\n                  <jats:p>We reviewed all the BM aspirates and biopsies of cirrhotic cases, done from 2011 to 2018 for clinical indications. Dyspoiesis was considered if &gt;5% of the precursor cells of any of the three lineages showed dyspoietic changes. Primary haematological or non-haematological malignancies, chronic kidney disease, drug intake, acute and chronic hepatitis and granulomatous disease were excluded.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 608 these, 82 cases (13.5%) showed dyspoiesis in the BM precursors. There was no difference in age (p=0.16), gender (p=0.58) and spleen size (p=0.35) in cases with or without dyspoiesis. Majority of the cases had dyspoiesis in erythroid series (62, 75.6%) and megakaryocytes (15, 18.2%). Dyspoiesis was more prominent in alcoholics 44 cases (53.6%) and autoimmune diseases 13 cases (15.8%). Erythroid hyperplasia (47.7\u00b114.4 vs 40\u00b111.1; p&lt;0.001) was more in cases with dyserythropoiesis, indicating ineffective erythropoiesis. Patients with dyspoiesis had lower haemoglobin (7.5\u00b11.9 vs 9.3\u00b12.2\u2009g\/dL, p&lt;0.001). 54 (8.07%) had refractory anaemia with dyspoiesis present in 48 (88.8%) (p&lt;0.01). Dyspoiesis was independently associated with refractory anaemia when adjusted for age, gender, aetiology and liver disease severity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>BM dyspoiesis, especially dyserythropoiesis, is associated with severe refractory anaemia in patients with cirrhosis and requires new therapeutic approaches.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/flgastro-2019-101350","type":"journal-article","created":{"date-parts":[[2020,2,4]],"date-time":"2020-02-04T17:15:47Z","timestamp":1580836547000},"page":"39-43","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Bone marrow dyspoiesis associated with severe refractory anaemia in liver cirrhosis"],"prefix":"10.1136","volume":"12","author":[{"given":"Annapoorani","family":"Varadarajan","sequence":"first","affiliation":[{"name":"Department of Hematology, Institute of Liver and Biliary Sciences, New Delhi, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepika","family":"Lal","sequence":"additional","affiliation":[{"name":"Department of Hematology, Institute of Liver and Biliary Sciences, New Delhi, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Radhika","family":"Kapil","sequence":"additional","affiliation":[{"name":"Department of Hematology, Institute of Liver and Biliary Sciences, New Delhi, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5801-9458","authenticated-orcid":false,"given":"Chhagan","family":"Bihari","sequence":"additional","affiliation":[{"name":"Department of Hematology, Institute of Liver and Biliary Sciences, New Delhi, Delhi, 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