title: [Clinical Significance of the Bone Marrow Morphological Differences in the Differential Diagnosis of Megaloblastic Anemia and Refractory Anemia].
abstract: OBJECTIVE
  To investigate the clinical significance of bone marrow morphological differences in the differential diagnosis of megaloblastic anemia (MM) and refractory anemia (R4).
  
  
  METHODS
  A total of 60 anemia patients selected from our hospital between April 2004 and April 2015 were divided into MA group (30 cases) and RA group (30 cases) in accordance with their clinical diagnosis. Clinical manifestations, results of bone marrow morphology test, blood examination, peripheral blood smear, erythroid megaloblastic variability rate and nucleated red blood cell level in the 2 groups were compared and analyzed.
  
  
  RESULTS
  Incidence of fever, hemorrhage, digestive reaction, splenomegaly and fatigue as well as hemoglobin level, platelets and white blood cell counts in patients of MA group were similar to those of RA group, there was no statistically significant difference between 2 groups (P>0.05). The percentages of dysplastic hematopoiesis in erythroid cells, granulocytic cells, magakaryoajtic cells, the PAS-positive rate and red blood cell distribution in the MA patients were obviously lower than those in the RA patients, while the erythroid megaloblastic variability rate (90%) in MA group was obviously higher than that in RA patients (10%) and with statistically significant difference (P<0.05). The percentage of immature red blood cells was similar between MA group (53.33%) and RA group (60.00%), without significant difference (P>0.05).
  
  
  CONCLUSIONS
  Most of clinical manifestations and peripheral blood smear results are consistent in MA patients and RA patients, bone marrow morphology detection in RA group should be focused on lymphocytoid micromegakaryocytes, while the erythroid megaloblastic cell body is the focus in MA group, PAS can be used as a diagnostic criteria.
authors.affiliation: Department of Laboratorial Examination, Haikou Third People's Hospital, Haikou 571100, Hainan Province, China. E-mail: 393966184@qq.com.
authors.forename: Min
authors.initials: M
authors.lastname: Wu
authors.affiliation: Department of Laboratorial Examination, 187th Hospital of Chinese PLA, Haikou 571100, Hainan Province, China.
authors.forename: Yi-Gui
authors.initials: YG
authors.lastname: Li
authors.affiliation: Department of Hematology, Sun Yat-Sen Memorial Hospital, Zhongshan University, Guangzhou 510120, Guangdong Province, China.
authors.forename: Da-Nian
authors.initials: DN
authors.lastname: Nie
authors.affiliation: Department of Laboratorial Examination, Haikou Third People's Hospital, Haikou 571100, Hainan Province, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Long
mesh_terms: D000749:Anemia, Megaloblastic / Q000175:diagnosis*; D000753:Anemia, Refractory / Q000175:diagnosis*; D001853:Bone Marrow / Q000473:pathology*; D003937:Diagnosis, Differential; D004906:Erythrocyte Count; D006801:Humans; D007958:Leukocyte Count; D008533:Megakaryocytes / Q000166:cytology