A Comparative Evaluation of Simultaneous Bone Marrow Aspiration And Bone Marrow Biopsy Interpretations In Routine Hematology Practice with Special Reference to Flow Cytometry And Cytogenetic Analysis

Abstract

Introduction: Bone Marrow examination is an important diagnostic tool to evaluate various hematological and non-hematological diseases including both neoplastic and non-neoplastic conditions. The two separate but inter-related techniques are used such as Bone marrow aspiration(BMA) and Bone marrow biopsy(BMB) along with in the recent days introduction of Flow cytometry analysis and cytogenetic study have taken an important diagnostic tool to reach a definitive diagnosis and all these diagnostic processes are complimentary to each other. Aim and objective: This study is aimed to assess and correlate the diagnostic value of simultaneous BMA and BMB along with Flow cytometric interpretations in different hematological malignancies and non-neoplastic hematological and nonhematological diseases to establish a final diagnosis. Materials And Methods: This study involved bone marrow analysis in 164 patients out of which in 158 cases both BMA and BMB was performed simultaneously along with flow cytometry and cytogenetic study was done on some hematological malignancies and a correlation was done between all these procedures. Criteria of inclusion included the main indications for performing this procedure, the availability of full clinical data and patient consent. Result: In the present study, out of 158 cases with simultaneous BMA and BMB procedures were performed simultaneously showed 85.4% positive correlation between these two procedures. However, it was found that in cases of myelofibrosis, non-hodgkin’s lymphoma, myeloproliferative disorders and granulomas, involvement of marrow was detected better in bone marrow biopsies. And also simultaneous flowcytometry and cytogenetic analysis gives strong confirmatory diagnosis in hematological malignancies to know the origin, genetic alteration and minimal residual disease in follow –up cases for targeted therapy. Conclusion: This study concludes that in routine hematological practice BMA, BMB, Flow cytometry and Cytogenetic, all are complimentary to each other which should be done simultaneously for the better diagnostic and prognostic point of view.