Value Of Bone Marrow Examination Research Articles

Hodgkin lymphoma in the bone marrow aspirate of a young patient with human immunodeficiency virus.

Hodgkin lymphoma in the bone marrow aspirate of a young patient with human immunodeficiency virus.

P-128: Value of bone marrow examination in determining response to therapy in patients with multiple myeloma in the context of mass spectrometry based M protein assessment

P-128: Value of bone marrow examination in determining response to therapy in patients with multiple myeloma in the context of mass spectrometry based M protein assessment

Indications and diagnostic value of bone marrow examination in HIV-positive individuals: A 3-year review at Tygerberg Hospital.

BackgroundBone marrow examination is a useful diagnostic tool in human immunodeficiency virus (HIV)-positive patients presenting with cytopenias and fever. However, its role in the afebrile and asymptomatic patient presenting with an isolated cytopenia is not well established. This study was conducted to determine the indications for bone marrow examination and its diagnostic yield, in HIV-positive patients at Tygerberg Hospital.MethodsA retrospective, cross-sectional descriptive study was performed over a 3-year period from 01 September 2015 to 31 August 2018. The bone marrow examination reports for the HIV-positive patients who had a bone marrow examination during the study period were retrieved. Clinical and laboratory information was captured.ResultsAltogether 374 bone marrow reports for HIV-positive patients were found. The indication of the bone marrow examination included investigation of unexplained cytopenias, suspected haematological malignancies, follow-up examination for patients with known haematological diseases, staging of haematological or non-haematological malignancies and investigation of suspected disseminated infection. The patients’ median age was 43 years and the interquartile range was 27–60 years. There was a slight female predominance with females 51% and males 49%. The diagnostic yield was 33.7%. Acute leukaemia and lymphoma were the most common diagnoses. Haematinic deficiency and pure red cell aplasia were found in the majority of cases with isolated anaemia. All cases with isolated thrombocytopenia were due to immune thrombocytopenia.ConclusionBone marrow examination is a useful investigation for HIV-positive patients with cytopenias, suspected haematological malignancy and lymphoma staging. However, its early use in patients with isolated anaemia and isolated thrombocytopenia is questionable.

Value of Bone marrow Examination in Pyrexia of unknown origin

Background: Pyrexia of unknown origin is a common diagnostic dilemma. Series of diagnostic modalities are required to arrive at diagnosis. Bone marrow examination is one of the common tests implicated in the diagnosis in combination with other diagnostic modalities. Present study has attempted to explore the causes of pyrexia of unknown origin based on bone marrow morphological study. Materials and Methods: In a one year prospective study conducted at Manipal Teaching Hospital, Pokhara, Nepal; bone marrow aspiration and biopsy was performed and evaluated morphologically, in 57 patients fulfilling the criteria of classic pyrexia of unknown origin. Results: In 42% cases; specific diagnosis could be made and hematological neoplasm was the most common finding followed by megaloblastic anemia, hypoplastic anemia and one case each of hemophagocytosis, malaria and tuberculosis. Acute leukemia was the most frequently encountered hematological malignancy followed by multiple myeloma, chronic myeloid leukemia, essential thrombocythemia and myelodysplastic syndrome. Conclusion: Morphological examination of bone marrow has important role in diagnosis of pyrexia of unknown origin. However, yield of diagnosis can be increased if it is combined with other diagnostic modalities including radiological, microbiological and serological tests. DOI: http://dx.doi.org/10.3126/jpn.v3i6.8991 Journal of Pathology of Nepal (2013) Vol. 3, 447-451

Value of bone marrow examination in Hodgkin lymphoma: Report of three cases with review of literature

Bone marrow involvement by Hodgkin lymphoma is rare with an average incidence of 10%. However, the incidence of bone marrow involvement has been shown to be less than 1% in patients with clinical stage IA or IIA disease. The involvement of the marrow in a patient with Hodgkin lymphoma represents stage IV disease. We report our experience wherein three cases of marrow involvement were picked up on bone marrow aspirates/ -imprints and confirmed on trephine biopsy. In this paper we wish to highlight the significance of bone marrow examination in the initial diagnosis and staging of even clinically early stage Hodgkin lymphoma. Staging investigations performed at the time of diagnosis for patients with Hodgkin lymphoma are vital for determining the appropriate treatment and prognosis.

Invasion of Erythroblasts by Pasmodium vivax: A New Mechanism Contributing to Malarial Anemia

Severe malarial anemia causes considerable mortality and morbidity in endemic areas. Possible mechanisms underlying the anemia include lysis of parasitized and nonparasitized red cells as well as parasite product-mediated effects on erythropoiesis. The latter include suppression of erythropoiesis, dyserythropoiesis, and ineffective erythropoiesis. Present transmission electron microscope data in two cases of Pasmodium vivax malaria show a hitherto undescribed mechanism contributing to malarial anemia, namely, infection of erythroblasts by parasites and their subsequent degradation. No parasites were detected in the peripheral blood but parasites were found in the bone marrow. These findings emphasise the value of bone marrow examination in the diagnosis and eradication of malaria.

The value of bone marrow examination in the staging of Hodgkin's lymphoma: a review of 955 cases seen in a regional cancer centre.

Bone marrow aspirates (BMA) and trephine biopsies (BMT) are commonly performed in the staging of patients with newly diagnosed Hodgkin's lymphoma (HL) but the value of these procedures is controversial. The purpose of this study was to evaluate the predictive value of the blood count and erythrocyte sedimentation rate (ESR) for bone marrow involvement (BMI) and the influence of BMI on stage and prognostic score. A retrospective analysis of 955 patients with newly diagnosed HL entered into clinical trials in a regional cancer centre between 1975 and 1999 was performed. BMI was identified by BMT in 50 patients (5.2%) but in only five of these by BMA. The negative predictive values of a normal full blood count (FBC) and ESR for absence of BMI were 98.8% and 97.3%, respectively, and the positive predictive value of an abnormal FBC and ESR for presence of BMI were both 6.7%. BMT did not alter initial patient management in a single case but provided valuable prognostic information in certain subgroups of patients. BMA gave no additional staging information over BMT and abnormalities of blood count and ESR were poor predictors of infiltration. We conclude that BMA should be abandoned for staging purposes in HL and BMT restricted to patients with stage IIB or III disease, for whom valuable prognostic information may be obtained.

Utility of bone marrow culture and biopsy in the diagnosis of disseminated infections in AIDS.

Bone marrow examination (BME) has been used as a diagnostic test of last resort in HIV infected patients. Identifying factors that would increase the diagnostic yield of BME would be useful. A retrospective cohort study was done to determine the predictive value of BME for disseminated infection in 133 patients with HIV infection in a 4-year period at an active HIV clinical center. Thirty-two percent of the cases had evidence of a disseminated infection on BME but only 10% of cases had a diagnosis made exclusively by BME. Multivariate analysis demonstrated that a positive result was more likely in those patients with fewer than 50 CD4 cells/mm3 and those with a hematocrit of less than 25% (P<0.01). BME can be a useful, low-risk diagnostic procedure in selected patients with HIV infection who are ill with a low CD4 count and/or have a hematocrit less than 25%. A diagnosis can usually be made by other means, suggesting that this test should be limited to those in whom other diagnostic modalities have been exhausted.

The value of bone marrow examination in small cell carcinoma of the lung: Horlyck A, Henriques U, Jakobsen A. Rugmarken 108, DK-8520 Lystrup. Acta Oncol 1994;33:909–911

The value of bone marrow examination in small cell carcinoma of the lung: Horlyck A, Henriques U, Jakobsen A. Rugmarken 108, DK-8520 Lystrup. Acta Oncol 1994;33:909–911

The value of bone marrow examination in small cell carcinoma of the lung.

Of 668 consecutive patients with SCLC, 472 underwent bone marrow examination for staging. In 330 patients a triple examination (sternal aspiration, iliac crest aspiration and biopsy) was performed, otherwise a single procedure. Bone marrow infiltration (MI) was found in 37% of the patients with extensive disease, and the frequencies of a positive finding in single and triple examination were not statistically different. In the group having triple examination performed iliac crest aspiration alone disclosed MI in 32%. When all three procedures were included still more patients with MI were found (42%) but the two values were not significantly different. In 6.6% of patients who would have been classified as 'limited' did bone marrow examination change the stage to extensive disease. Based on these results we recommend iliac crest aspiration, but not triple examination with iliac crest biopsy, in the staging of SCLC.

The value of bone marrow examination for tumor staging in breast cancer.

The purpose of our study was to investigate the value of cytokeratin antibodies for identifying bone marrow involvement in breast cancer patients who showed no evidence of distant metastases using noninvasive tumor staging procedures. Bone marrow for histological (biopsy) and immunocytochemical (aspiration) evaluation was obtained from the anterior iliac crest from 50 unselected consecutive women during surgical treatment of the primary tumor. The histological examination was done on nondecalcified bone sections. The immunocytochemical studies were carried out on interface smears of the bone marrow aspirates. For staining, cytokeratin antibodies (PKK 1) and the immune alkaline phosphatase method was used. Cytokeratin-positive cells were found in 4 of the 50 cases (8%). Of those 4 patients, however, 2 also showed evidence of neoplastic bone marrow infiltration histologically. We thus were able to prove that immunocytochemistry on aspirates is superior to conventional histology in identifying tumor in bone marrow. Nonetheless, our results clearly fell below the rate found in previous studies where epithelial membrane antigen antibodies were used.

Diagnostic value of bone marrow examination in isolated thrombocytopenia.

Bone marrow examination often is performed to assess isolated thrombocytopenia. A three-year retrospective study demonstrates that bone marrow aspiration in isolated thrombocytopenia predictably shows megakaryocytic thrombocytopenia. Little additional information is obtained by bone marrow examination that cannot be determined by noninvasive tests. In this series, the Jamshidi biopsy did not add significant information to that obtained from the aspirate. The authors conclude that bone marrow examination is not necessary in patients with isolated thrombocytopenia. In acute care hospital patients, the cause of the thrombocytopenia usually is apparent from the clinical history, and bone marrow examination is necessary infrequently.

Methods and prognostic value of bone marrow examination in small cell carcinoma of the lung

The technique and predictive value for survival of initial and restaging bone marrow examinations in small cell carcinoma (SCC) of the lung were evaluated by 76 examinations of 72 patients. In 76 examinations, only 2 (2.6%) of the bilateral iliac crest bone marrow examinations revealed tumor cells unilaterally and these two were restaging examinations. If SCC was found in the marrow, bone marrow biopsy was always positive. In no instance was an aspirate positive with a negative bone marrow biopsy. Thus a unilateral bone marrow biopsy is an adequate technique for the initial staging of the bone marrow in SCC of the lung. Survival of patients with or without positive initial bone marrow examinations was not significantly different.