ICSH guidelines for the standardization of bone marrow specimens and reports

Abstract

Summary The bone marrow examination is an essential investigation for the diagnosis and management of many disorders of the blood and bone marrow. The aspirate and trephine biopsy specimens are complementary and when both are obtained, they provide a comprehensive evaluation of the bone marrow. The final interpretation requires the integration of peripheral blood, bone marrow aspirate and trephine biopsy findings, together with the results of supplementary tests such as immunophenotyping, cytogenetic analysis and molecular genetic studies as appropriate, in the context of clinical and other diagnostic findings. Methods for the preparation, processing and reporting of bone marrow aspirates and trephine biopsy specimens can vary considerably. These differences may result in inconsistencies in disease diagnosis or classification that may affect treatment and clinical outcomes. In recognition of the need for standardization in this area, an international Working Party for the Standardization of Bone Marrow Specimens and Reports was formed by the International Council for Standardization in Hematology (ICSH) to prepare a set of guidelines based on preferred best practices. The guidelines were discussed at the ICSH General Assemblies and reviewed by an international panel of experts to achieve further consensus.

Comparison Between 1-Needle Technique Versus 2-Needle Technique for Bone Marrow Aspiration and Biopsy Procedures

“…2013;137:974-978; doi: 10.5858/ arpa.2012-0046-OA) E xamination of bone marrow sample is essential in diagnosing and staging of hematologic diseases and in the subsequent monitoring and management required for patient follow-up. [1][2][3][4][5][6][7][8][9][10] The procedure typically involves obtaining a sample of bone marrow aspirate fluid and a core biopsy. 5 Examination of material obtained by aspiration, combined with a trephine biopsy, allows for the most thorough morphologic assessment of the marrow.…”

Immunohistochemistry- Not As Sensitive As Expected For Detecting Bone Marrow Micrometastases In Cases Of Epithelial Malignancies?

“…Paraffin sections were deparaffinised and rehydrated. After antigen retrieval by microwave method in ready to use antigen retrieval solution as per the standard protocol; IHC staining for CK7 and CK20 were done [19,20] . Control samples were also run along with the IHC and sections were screened and reported by three separate observers.…”

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

“…Aspirations were performed after obtaining informed consent and documented. BMA procedures were performed using a standard unit protocol as adapted from ICSH guidelines (1,7). Bone marrow was aspirated from posterior superior iliac crest under local anesthesia using lignocaine solution.…”