Bone marrow aspiration: the diagnostic tool in haematological and non-haematological disorders

ABSTRACT

This study was undertaken to ascertain various clinical conditions requiring bone marrow examination and to assess its advantages in our clinical setup. This study is case series, which was carried out at the Department of Pathology, Combined Military Hospital, Sialkot Cantt from 1[st] Jun 2005 to 31[st] Dec 2007. One hundred and six bone marrow examinations were performed from 1[st] June 2005 till 31[st] Dec 2007. Patients of all age groups and gender referred for bone marrow examination were included in the study. After history, clinical examination and blood complete counts, about 0.1 and 0.2 ml of bone marrow was aspirated from posterior superior iliac spine, sternum or tibia under local anesthesia or Ketamine as per age. Well spread films were made immediately and air dried. The smear was stained with Leishman stain and Peri's stain and assessed by examination under microscope. The patient's ages ranged from 06 months to 80 years with a mean age of 38 years. Twenty five patients were children under the age of 15 years and 81 were adults. Male to female ratio was 21. The clinical presentation of the patients was progressive pallor [50], fever of unknown origin [13] and bleeding [6]. The common clinical situations where bone marrow examination was requested were the presence of anaemia 37[34.9%], leukaemia 25 [23.5%], myelodysplastic syndrome 7 [6.6%], multiple myeloma 5 [4.7%], chronic disorders 10 [9.4%] and non-haematological conditions 8 [7.5%]. Diagnosis was established in >/= 90% cases. Bone marrow examination remains a simple, reliable and the most effective technique in the diagnosis of many important clinical conditions.It is an important and readily accessible tool for diagnosing various haematological and non-haematological conditions. The importance of bone marrow examination is further highlighted in cases where routine investigations fail to reach a conclusive diagnosis