Pancytopenia Workup

A 52-year-old man with a 6-month history of pancytopenia undergoes bone marrow examination showing normocellular marrow with 8% blasts and dysplastic changes in all three cell lines. Cytochemical stains show MPO-positive blasts. Which investigation is most appropriate to confirm the diagnosis and assess prognosis?

A 28-year-old man with pancytopenia undergoes bone marrow examination. The marrow is hypocellular with no dysplastic changes and normal cytogenetics. Serum B12 and folate levels are normal. Which single feature best distinguishes acquired aplastic anemia from inherited bone marrow failure syndromes (e.g., Fanconi anemia) in this patient?

A 52-year-old man with a 6-month history of progressive pancytopenia (Hb 8.5 g/dL, WBC 1.8 × 10⁹/L, platelets 35 × 10⁹/L) has a hypocellular bone marrow with no dysplasia or fibrosis. Viral serology and metabolic workup are normal. What is the drug of choice for severe aplastic anemia?

A 38-year-old woman from rural Maharashtra presents with a 3-month history of progressive fatigue, dyspnea on exertion, and recurrent oral ulcers. On examination, she is pale with petechiae over the lower limbs and hepatosplenomegaly. Laboratory investigations reveal: Hemoglobin 7.2 g/dL, WBC 2,100/μL, platelets 45,000/μL, reticulocyte count 0.8%, and normal B12 and folate levels. Bone marrow aspiration shows hypocellular marrow with 2% blasts. What is the most likely diagnosis?

A 38-year-old woman from rural India presents with pancytopenia (Hb 7.2 g/dL, WBC 2.1 × 10⁹/L, platelets 45 × 10⁹/L). Bone marrow biopsy shows hypocellular marrow with increased fat spaces. Which of the following investigations is NOT routinely indicated in the initial workup of suspected aplastic anemia?