DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20182817

Bone marrow aspiration in haematological disorders: study at a tertiary care centre

Subuh Parvez Khan, Sajad Geelani, Shareefa Akhter, Shuaeb Bhat, Saleem Hussain, Fahim Manzoor, Javid Rasool, Fiza Parvez Khan

Abstract


Background: The bone marrow examination is an essential investigation for the diagnosis and management of many disorders of the blood and bone marrow. Bone marrow aspiration (BMA) alone is usually sufficient to diagnose nutritional anaemias, and most of the acute leukaemias. Aim was to study the spectrum of haematological disorders diagnosed on bone marrow aspiration.

Methods: This study was conducted in the Department of Clinical Haematology in Sher e Kashmir Institute of Medical Sciences, Kashmir for a period of 2 years from December 2015 to December 2017. Bone marrow examination of 2131 cases of suspected hematological disorders was carried out. Bone marrow was aspirated from posterior superior iliac spine under local anaesthesia. Aspirates of dry tap were excluded from the study. Aspiration smears where stained with Leishmann stain for morphological examination.

Results: A total of 2131 cases were included in this study. Male to female ratio in our study was 1.9:1. The age range of cases was from 1-80 years and the mean age was 47.3 years. Anemia was the most common haematological disorder in our study accounting for 25.6% of cases followed by acute leukaemia accounting for 22.3% and multiple myeloma (13.3%). Among anemias, megaloblastic anemia was most common followed by dual deficieny anemia. Among leukaemias, acute myeloid leukaemia (13.2%) was more common than acute lymphoblastic leukaemia (9.1%).

Conclusions: Bone marrow aspiration cytology is a mildly invasive technique which can diagnose many hematological and non-hematologic diseases that can be confirmed by more advanced investigations viz. serological, biochemical or molecular. It is a highly informative test procedure performed for evaluating blood and blood related diseases in our environment.


Keywords


Anemia, Bone marrow aspiration, Leukaemia

Full Text:

PDF

References


Bain BJ. Bone marrow aspiration. J Clin Pathol. 2001;54:657-63.

Ryan DH, Felgar RE. Examination of the marrow. In: Lichtman MA, Kipps TJ, et al (eds). William’s haematology 7th ed. New York, McGraw Hill. 2006;3:21-31.

Gluckman E. Choice of the donor according to HLA typing and stem cell source. Apperley J, Carreras E, Gluckman E, Masszi T (eds). Haemotopoietic Stem cell transplantation. EBMT Handbook 6th ed. 2012;6:90-107.

Bolan CD, Kurlander RJ, Schechter GP. Interpretation of standard hematologic tests. In: Rodgers GP, Young NS. The Bethesda handbook of clinical hematology. 3rd ed. 2013;27:405-426.

Lee SH, Erber WN, Porwit A, Tomonaga M, Peterson LC, International Council for Standardization In Hematology. ICSH guidelines for the standardization of bone marrow specimens and reports. Inter J Lab Hematol. 2008 Oct;30(5):349-64.

Niazi M, Raziq FI. The incidence of underlying pathology in pancytopenia-an experience of 89 cases. JPMI. 2004;18:76-9.

Adewoyin AS, Ezire ES, Adeyemi O, Idubor NT, Edewor-Okiyo DO. Bone Marrow Aspiration Cytology Studies In A Tertiary Hospital, Nigeria: A Serie Of 88 Cases. Annals of Pathology and Laboratory Medicine. 2015 Oct 26;2(4):A107-114.

Atla BL, Anem V, Dasari A. Prospective study of bone marrow in haematological disorders. Int J Res Med Sci. 2015 Aug;3(8):1917-1921.

Ranabhat S, Maharjan S, Tiwari M, Bhandari A, Osti BP. Bone marrow aspiration cytology in the diagnosis of hematologic and non-hematologic diseases in a multi-specialty hospital in Nepal. Inter J Res Med Sci. 2017 Feb 20;5(3):922-6.

Pudasaini S, Prasad KBR, Rauniyar SK, Shrestha R, Gautam K, Pathak R, et al. Interpretation of bone marrow aspiration in hematological disorder. J Patho Nepal. 2012;2:309-12.

Ghartimagar D, Ghosh A, Narasimhan R, Talwar OP. Patterns of hematological and non-hematological malignancies in bone marrow in a tertiary care hospital in Nepal-11 years study. NMCJ. 2012 Sep;14(3):187-92.

Kibria SG, Islam MDU, Chowdhury ASMJ. Prevalence of hematological disorder: a bone marrow study of 177 cases in a private hospital at Faridpur. Faridpur Med Coll J. 2010;5:11-3.

Egesie OJ, Joseph DE, Egesie UG, Ewuga OJ. Epidemiology of anemia necessitating bone marrow aspiration cytology in Jos. Niger Med J. 2009;50:61-4.

Gayathri BN, Rao KS. Pancytopenia: a clinic hematologicl study. J Lab Physicians. 2011;3:15-20.

Jha A, Sayami G, Adhikari RC, Panta D, Jha R. Bone marrow examination in cases of pancytopenia. J Nepal Med Assoc. 2008;47:12-7.

Khodke K, Marwah S, Buxi G, Yadav RB, Chaturvedi NK. Bone marrow examination in cases of pancytopenia. JIACM. 2001;2:55-9.