Bone Marrow Aspiration Cytology Studies In A Tertiary Hospital, Nigeria: A Serie Of 88 Cases
Keywords:
Bone Marrow Examination, Bone Marrow Aspiration, Cytology, Trephine BiopsyAbstract
BACKGROUND: Bone marrow aspiration (BMA), an invasive test is crucial in evaluation of anaemias and other blood diseases, especially in situations where diagnosis remains cryptic after detailed clinical history, physical examination and peripheral blood analysis. BMA is performed by trained haematologists in the course of evaluating patients with primary or secondary haemopathies. However, there is sparse local data/report on its clinical utility. This study therefore assessed the common clinical indications, diagnostic findings and associated complications in our locality.
METHODOLOGY: A prospective cohort study of 88 cases of BMA procedures among patients managed and co-managed by the adult haematology unit at the University of Benin Teaching Hospital (UBTH), Benin City was carried out. Relevant demographic, clinical data and intra-procedure details were obtained using a structured questionnaire within 24 hours of the procedure during the study period through case file review and patient interview. Intra-procedure intensity was graded in patients above 14 years using numeric pain scale of 0 to 10. All patients were followed up for a period of 1 to 2 weeks post-procedure.
RESULT: The mean (SD) of the subject was 40 ± 24 years. Most (79.5%) of the BMA cytology were performed among adults (≥15 years of age), mostly on in-patient basis (86.4%). Posterior iliac crest was the most commonly used site (83%). Aspiration yield was adequate in 83% of cases. Mean intra-procedure pain score was 5.17 ± 2.01. Most common bone marrow diagnoses were combined (substrate) deficiency (26.1%), acute leukaemias (18.2%), pure megaloblastic anaemia (10.2%), malignant plasmacytosis (7.9%) and marrow carcinomatosis (7.9%). Pain was the most frequent complication, observed in 98.9% of cases.
CONCLUSION: BMA cytology is a highly informative/diagnostic test procedure performed by haematologists in evaluating blood and blood related diseases in our environment. BMA is relatively safe although significant procedure related pain was frequently reported. Efforts should therefore be directed at better analgesia. Patients with unexplained cytopenias and other relevant indications should be referred for haematology consultation and possible BMA.References
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Copyright (c) 2015 Ademola Samson Adewoyin, Enifome S Ezire, Oluwafemi Adeyemi, Nosakhare T Idubor, Deborah O Edewor-Okiyo
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