Bone Marrow Aspiration and Bone Marrow Biopsy in Hematological Malignancies - A 10 Year Clinicopathological Study

Abstract

Introduction: Hematological malignancies may derive from either of the two major blood cell lineages- Myeloid and lymphoid cell lines. Lymphoma, lymphocytic leukemias and myeloma are from the lymphoid line, while acute and chronic myelogenous leukemia, myelodysplastic syndromes and myeloproliferative diseases are myeloid in origin. Objectives : The present study (2002 - 2012) has been aimed to report our bone marrow aspiration and biopsy examination experience with one hundred seven (107) patients of hematological malignancies from North India. and compare the results of bone marrow aspirations with bone marrow biopsy. Material and Methods: In our study we have included cases of hematological malignancies (Leukemia, Malignant Lymphoma and Multiple Myeloma). In each case serial bone marrow aspiration and biopsy were done before and after chemotherapy and radiotherapy. Aspirate particles, smears, touch imprints of the biopsy core and paraffin sections of the biopsy core were routinely examined. Results: Out of these one hundred seven (107) cases of hematological malignancies, non-Hodgkin's lymphoma (NHL) were maximum thirty cases (28.03%), followed by chronic myeloid leukemia (CML) twenty cases (18.69%), acute lymphoblastic leukemia (ALL) fifteen cases (14.01%), acute myeloid leukemia (AML) twelve cases (11.21%), multiple myeloma (MM) eleven cases (10.28%), chronic lymphocytic leukemia (CLL) ten cases (09.34%), Hodgkin's lymphoma (HL) eight cases (07.47%) and hairy cell leukemia (HCL) one case (0.93%). Conclusion: Hematological malignancies were more prevalent in males and more common in first and third decades of life followed by fifth decade In this study bone marrow aspiration was found adequate in hematological malignancies especially in leukemia. Trephine biopsy is essential for diagnosis, when a dry tap or bloody tap occurs as a result of fibrotic or very densely cellular bone marrow. There is virtually no contraindication to aspiration and needle biopsy of the bone marrow. In malignant lymphomas, which are infiltrating to bone marrow, bone marrow biopsy (BMB) was found superior to bone marrow aspiration (BMA) as well as bone marrow involvement is a less favorable prognostic sign than the patients without bone marrow involvement.