Comparison of bone marrow aspiration and biopsy as diagnostic tool in pediatric age group

Abstract

Objectives: Bone marrow examination is the final endpoint to the diagnosis of many haematological and nonhaematological disorders when all other clinical diagnostic tools have been done with. It consists of two tests each of which has their own role in making a final diagnosis. First bone marrow aspiration and second bone marrow biopsy. They complement each other and together provides a complete picture of the bone marrow. The study aimed to assess the diagnostic accuracy and to observe the degree of correlation (kappa value) between the two procedures. Material and Methods: This retrospective study was conducted in the department of pathology of our institution from July 2021 to August 2022. In 149 cases, both BMA and BMB was performed simultaneously and was included in the study. BMA slides was stained with Leishman Giemsa stain and BMB underwent tissue decalcification and tissue processing followed by staining with haematoxylin and eosin stain. Other special stains such as PAS, Reticulin and Perl’s, ZielNeelson (ZN) stain were also done on all relevant cases. Data were analyzed using Graphpad Instat 3 and Prism 5. Results: The mean age was 8.23±4.37. Of these, the Male: Female ratio was 1.8:1. The most commonly correlated diagnosis in the lower age group were for iron deficiency anemia (100%), Childhood Acute Leukemia (87.2%) and in higher age groups, the most correlated diagnosis were for Chronic myeloid Leukaemia (100%) and Acute Myeloid Leukaemia (72.72%). Kappa value in our study revealed that there was substantial agreement (0.6295) between the two procedures. the diagnostic efficacy of BMA is 77.18% and for BMB is 90.6%. Conclusion: Bone marrow aspiration and biopsy have upperhand over each other in their respective area. Both shows substantial agreement and hence these should be performed together and not in isolation to give a complete diagnosis.