Clinical Study of Bone Marrow by the Method of Sternal Puncture

Abstract

The material was secured by sternal puncture by a technique similar to that of Arinkin. More than 50 cases were used representing a wide variety of clinical conditions. Smears made from the marrow material were stained with Wright's stain, Cresyl blue reticulocyte stain, Giemsa stain and peroxidase stains, no variations in technique being made from that of peripheral blood smears. This report is limited to a discussion of the Wright stained preparations. The marrow cells are well-preserved and stained. Differential counts of the marrow cell elements have been made. The average of 7 cases with a normal peripheral blood picture was the following cells: Myeloblasts 2.4%; myelocytes 7%; Jung Kernige 6.7%; Stag Kernige 14%; II Segment Neutrophiles 10%; III Segment Neutrophiles 6.3%; IV, V, etc., Segment Neutrophiles 1.1%; Eosinophiles 1%; Basophiles 0.3%; Monocytes and Reticuloendothelial elements 9%; Lymphoid Cells 24.9%; Megaloblasts 5.2%; Normoblasts 6.9%; Primitive Cells 2.6%. These findings agree rather closely with those of Arinkin on similar types of cases. The high percentage of immature granulocytes in our counts confirms the concept of Arneth and Schilling that the neutrophilic nucleus changes progressively with age from the round to the segmented form. The high percentage of juveniles and stabs confirms the idea that these are “young” granulocytes. Cells indistinguishable by Wright's stain from the lymphocytes of peripheral blood are present in practically all of our bone marrow preparations. These we have designated as lymphoid cells. Certain small primitive cells and young myeloblasts may be included in this group. The percentage of lymphoid cells is definitely greater than would be expected from the possible contamination with lymphocytes of peripheral blood. We have not attempted a separation of lymphoblasts from myeloblasts in the Wright stain preparations— all are termed myeloblasts except in the case of lymphatic leukemia.