DIAGNOSTIC SIGNIFICANCE OF BONE MARROW EXAMINATION AMONGST THE PATIENTS WITH ABNORMAL HAEMATOLOGICAL PARAMETERS

Authors

  • Saima Bashir Army Medical College, National University of Medical Sciences Rawalpindi
  • Fahim Akhtar Army Medical College Rawalpindi , National University of Medical Sciences Rawalpindi
  • Misbah Salim Combined Military Hospital Kharian
  • Maham Arshad Army Medical College, National University of Medical Sciences Rawalpindi
  • Zahra Tasleem Khan Armed Forces Institute of Pathology Rawalpindi
  • Farhan Akhtar Army Medical College, National University of Medical Sciences Rawalpindi

DOI:

https://doi.org/10.55519/JAMC-04-12357

Keywords:

Bone Marrow Biopsy, Cytology, Morphology

Abstract

Background: Bone Marrow examination is considered to be the most indispensable diagnostic tool for the evaluation of many neoplastic and non-neoplastic haematological disorders. After an initial assessment of suspicious cases on abnormal laboratory parameters along with the clinical presentation of the patient bone marrow examination is finally required for diagnosis as well as management of many haematological malignancies as it offers a clear cytological as well as histological picture of Bone Marrow aspirate and biopsy respectively. The Objective was to evaluate the significance of Bone Marrow examination in patients with abnormal haematological parameters. Methods: A retrospective study conducted at the Pathology Department of Pak Emirates Military Hospital from (Jan–June 2022) On data from 150 patients who were advised to undergo bone marrow examination due to abnormal lab parameters and peripheral smear findings after informed consent and approval from the ethics review committee, to find out the correlation of abnormal haematological parameters and aspirate findings which have led to a definitive diagnosis. Data comprising basic demographic variables (age, gender etc.), Abnormal Haematological Parameters (CBC), peripheral smear findings and Aspirate findings were analyzed using SPSS version 23.0. Results: Out of 150 studied participants with abnormal haematological parameters 24 (16%) were diagnosed on bone marrow examination as acute leukaemia / Hodgkin’s and Non-Hodgkin’s lymphoma respectively, 13 (9%) cases of aplastic anaemia and Autoimmune Haemolytic Anaemia, 33 (22%) cases of hypersplenism, CML and multiple myeloma. While 22 (15%) cases were diagnosed with BME as CKD and reactive changes. Moreover, 22(15%) cases were found to have Iron Deficiency anaemia respectively. Conclusion: The study revealed that patients with abnormal haematological parameters should undergo bone marrow examination to ascertain the diagnosis for malignant as well as non-malignant conditions that could cause abnormal lab parameters.

Author Biographies

Saima Bashir, Army Medical College, National University of Medical Sciences Rawalpindi

 

Fahim Akhtar, Army Medical College Rawalpindi , National University of Medical Sciences Rawalpindi

 

Misbah Salim, Combined Military Hospital Kharian

 

Maham Arshad, Army Medical College, National University of Medical Sciences Rawalpindi

 

Zahra Tasleem Khan, Armed Forces Institute of Pathology Rawalpindi

 

Farhan Akhtar, Army Medical College, National University of Medical Sciences Rawalpindi

 

References

Dogan A, Demircioglu S. Diagnostic importance of bone marrow aspiration evaluation: A single- center study. 2022;38(4Part-II):811–5.

Ebrahim H, Fisha T, Debash H, Bisetegn H. Patterns of Bone Marrow Confirmed Malignant and Non-Malignant Hematological Disorders in Patients with Abnormal Hematological Parameters in Northeast Ethiopia. J Blood Med 2022;13:51–60.

Bharuthram N, Feldman C. The diagnostic utility of bone marrow examination in an infectious disease ward. South Afr J HIV Med 2019;20(1):974.

Kumar V, Bhatia A, Madaan GB, Marwah S, Nigam A. Role of bone marrow examination in the evaluation of infections: clinico-hematological analysis in a tertiary care centre. Turk J Patholoji Derg 2020;36(1):17–22.

Sami A, Khan MI, Iqbal S. Diagnostic utility of bone marrow aspiration biopsy in definitive diagnosis in cases of hepatosplenomegaly. Prof Med J 2021;28(02):214–7.

Ansari JN, Baravkar A, Joshi RV, Pandy A, Rajendra SN, Iqbal B. Bone Marrow Aspiration: A Diagnostic Tool In Understanding The Broad-Spectrum Of Hematological Disorders: A 15-Year Study. Eur J Pharm Med Res 2017;4(7):236–40.

Fattizzo B, Zaninoni A, Gianelli U, Zanella A, Cortelezzi A, Barcellini W. Prevalence of Bone Marrow Fibrosis in 47 cases of Autoimmune Hemolytic Anemia Patients: Blood 2017;130:(Suppl 1):3491.

Balasubramanian M, Sangoi NN. Utility of Bone Marrow Examination in Pediatric Age Group: Experience of a Tertiary Healthcare Centre in India. Cureus 2022;4(7):e27056.

Tashfeen S, Asif N, Nasir S, Azam M, Irshad Z. Haematological Disorders Diagnosed in One Hundred and One Successive Bone Marrow Examination at a Tertiary Care Centre in Quetta, Balochistan. Pak Armed Forces Med J 2021;71(2):672–5.

Das R, Mandal AP, Ghosh M, Sengupta M. Comparison of bone marrow aspiration and biopsy as diagnostic tool in pediatric age group. J Hematol Allied Sci 2023;3(1):11–7.

Sai SK, Padhi S, Varghese RGB, Kanungo R, Basheer A, Iqbal N. Diagnostic utility of bone marrow examination in evaluation of fever: a descriptive study on 98 immunocompetent adults from a tertiary care institute in south India. Trop Doct 2019;49(2):88–96.

Tashfeen S, Asif N, Nasir S, Azam M, Irshad Z. Bone Marrow Examination. Pak Armed Forces Med J 2021;71(2):672–5.

Manzoor F, Bhat S, Bashir Y, Geelani S, Rasool J, Bashir N. Diagnostic Outcome of Bone Marrow Aspiration– An Experience from Tertiary Care Hospital. J Med Sci Clin Res 2018;8(8):585–9.

Joshi-Warpe S, Wader J, Warpe BM. Bone marrow aspiration and bone marrow biopsy in haematological disorders. Biomed Pharmacol J 2020;13(2):799–804.

Abdullah I, Subramony N, Musekwa E, Nell EM, Alzanad F, Chetty C, et al. Indications and diagnostic value of bone marrow examination in HIV-positive individuals: A 3-year review at Tygerberg Hospital. S Afr J Infect Dis 2021;36(1):273.

Additional Files

Published

2023-12-22