Bone marrow biopsy morbidity and mortality: 2002 data

Abstract

A survey of morbidity and mortality of bone marrow aspiration and trephine biopsy was carried out for the British Society of Haematology, covering the 12 months of 2002. Fifty-three centres reported 13,506 procedures, comprising 3927 aspiration biopsies and 9579 combined procedures. There were 17 adverse events including nine instances of haemorrhage, four infections and one haemorrhage complicated by infection. Two trephine biopsy needles broke during the procedure. One patient suffered considerable pain for 2 weeks. The adverse event may have contributed to death in two patients and in a third patient was life-threatening. Risk factors for adverse events were identified.

The European Consensus on grading of bone marrow fibrosis allows a better prognostication of patients with primary myelofibrosis

“…The fact that primary myelofibrosis is a continuously evolving disorder requires the use of a dynamic prognostic scoring system such as the International Working Group for Myelofibrosis Research and Treatment. On the other hand, the extremely low number of complications related to the bone marrow biopsy procedure, which in the more recent series is lower than 0.1-0.5%, 22 supports the execution of subsequent bone marrow biopsies to evaluate directly the evolution of marrow fibrosis. This procedure could allow monitoring the progressive stromal changes that become difficult to reverse in advanced stage (collagen fibrosis) and contribute to identifying the most appropriate therapeutic choice.…”

Limited clinical value of regular bone marrow cytogenetic analysis in imatinib-treated chronic phase CML patients monitored by RQ-PCR for BCR-ABL

“…It results in discomfort and inconvenience for patients and in rare cases, more serious complications. 30,31 These considerations have led us to question the need for routine follow-up of all CML patients with bone marrow aspiration and karyotyping where reliable and sensitive RQ-PCR is available.…”

Trained clinical nurse specialists proficiently obtain bone marrow aspirates and trephine biopsies in a nearly painless procedure—a prospective evaluation study

“…After finishing the BME, all patients first received 5 min of pressure by the thumb on the BME incision site and then rested for 15 min on a compression bag if they presented no risk factors for bleeding [28][29][30][31]. In the presence of low molecular weight heparin or thrombocytopenia (<50,000 platelets/μl), this was increased to 30 min, and in patients with therapeutic warfarin or acetylsalicylic acid (ASS) that could not be discontinued for a few days due to serious comorbidities, up to 60 min of rest on a compression bag was applied.…”