Bone marrow aspiration cytology in the diagnosis of hematologic and non-hematologic diseases in a multi-specialty hospital in Nepal

Abstract

Background: Peripheral blood smear examination and other routine laboratory assays are not always sufficient to diagnose various diseases which affect the blood and bone marrow. A bone marrow aspirate examination is essential in most of the cases.Methods: This work was a hospital-based cross sectional analytical observational study carried out in the department of pathology at the Chitwan Medical College, Teaching Hospital, Nepal, over a period of 3 years from January, 2013 to December 2015. Bone marrow was aspirated from posterior superior iliac crest under local anesthesia; sternum was the alternative site in obese patients. Univariate analysis was performed for each variable using frequency distribution and means with the help of Statistical Package for Social Sciences 20.0 (SPSS 20.0) software.Results: One hundred and fifty-nine patients were included in the study. Eight cases of 'dry tap' were excluded, for whom bone marrow biopsy was advised. Anemia was the largest group followed by malignancy, infection and miscellaneous diseases. Among anemia, megaloblastic anemia was the most common, followed by aplastic anemia, dyserythropoietic anemia and myelopthisic anemia. The category 'malignancy' consisted of leukemia, multiple myeloma and myelodysplastic syndrome. Regarding individual diseases, megaloblastic anemia was the most common haematological disorder followed by immune thrombocytopenic purpura, leukemia and aplastic anemia.Conclusions: Bone marrow aspiration cytology is a mildly invasive technique which can diagnose many haematological and non-hematologic diseases that can be confirmed by more advanced investigations, if needed: serological, biochemical or molecular. However, bone marrow sample cannot be obtained (dry tap) in a proportion of cases. In such cases, a bone marrow biopsy needs to be performed.

Prevalence of Different Types of Anaemias in Patients having Haemoglobin below 8gm% at a Tertiary Care Hospital in Jalandhar

“…Other than nutrition deficiency, Leukemia came out to be the most common diagnosis of anaemia in our study. Leukemia as a group was the most common malignant disorder (15%) and acute myeloblastic leukemia was found to be the most common type of leukemia in our study as in other studies [10] . Majority of the leukemia patients presented with Pancytopenia.…”

“…Females are more affected by Fe deficiency Anaemia than males. Although globally, the most significant contributor to the onset of anaemia is iron deficiency but it comes out to be the third most common cause in our study because Bone marrow examination is usually not required to establish the Fe deficiency [10].…”

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

“…8 Similar result was seen by Ranabhat S et al, with megaloblastic anemia being most common. 9 Adewoyin AS et al, conducted a study where anemia constituted most common aspiration haematological disorder with combined (substrate) deficiency (26.1%) being the predominant one. 7 Acute leukaemia was the second largest group accounting for 22.3% with acute myeloid leukaemia constituting 13.2%.…”

Bone Marrow Aspiration Evaluation in Clinical Management of Anemia Among Low Socioeconomic Group In A Tertiary Care Hospital.

“…Iron deficiency occurring concurrently with megaloblastic anemia has been reported in many studies. In some instances, the megaloblastosis may be intermediate in degree but may become more marked after administration of iron, and some cases of severe dimorphic anemia do not respond initially to iron therapy, probably owing to concomitant severe folate and occasionally Vitamin B12 deficiency (15 In our study,isolated iron deficiency was equally distributed among males(50%) and females(50%) whereas combined deficiency of B12 and folate appear to be more common in males than females.In Studies by Ranabhat S et al (16) and Chand N et al (17) the diseases were more common in females. According to a study conducted by Gayathri and Rao(18) the most common cause of pancytopenia was megaloblastic anemia (74%).In our study,among the cases investigated for pancytopenia 2 cases each of combined deficiency and megaloblastic maturation and 5 cases of plasma cell myeloma were diagnosed.…”