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Results for “Bone Marrow Examination”

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PubMed1979

Bilateral bone-marrow examinations in small-cell anaplastic carcinoma of the lung.

Bilateral bone-marrow examinations from the posterior iliac crests were routinely performed as a pretreatment staging procedure in 89 consecutive patients with small-cell anaplastic carcinoma of the lung. Bone-marrow involvement was found in 20 patients (22.5%), in 9 (10.1%) only on one side, and in 11 (12.4%) on both sides. Aspiration was found to be significantly superior to biopsy, being positive in 25 examinations as compared with 14 positive biopsies. Compared with unilateral bone-marrow examination the positive findings increased by approximately 30%. Bilateral bone-marrow examinations are recommended in patients in whom the detection of bone-marrow metastases will have therapeutic implications.

Biopsy, Needle↗
PubMed1989

A prospective analysis of 620 bone marrow examinations in Zimbabwe: preliminary observations.

Of the 1,310 bone marrow examinations performed in a 16-month period in patients with diverse haematological, oncological and other disorders, 620 had sufficient data for analysis. Seventy-nine percent were from the two main hospitals viz: Parirenyatwa and Harare Central Hospitals. Investigation for anaemia (42.6 percent), staging of malignant disease (14.4 percent) and pancytopenia (10.3 percent) formed the commonest triad of indications for requesting the examination. There were 318 (51 percent) males, mean age +/- s.d. of 33.8 +/- 22.6 years (range 6 months to 80 years); and 302 (49 percent) females, mean age +/- s.d. of 32.6 +/- 20.7 years (range 6 months to 78 years) giving a male to female ratio of 1.1:1. Of the 620 patients studied, 452 (73 percent) were adults (M:F ratio of 1:1) mean age +/- s.d. of 42.8 +/- 17.3 years (range 16-80 years); and 168 (27 percent) were children (M:F ratio of 1.1:1) mean age +/- s.d. of 7.3 +/- 4.5 years (range 6 months to 15 years). The three commonest diseases in the combined (adults and children) group were: megaloblastic anaemia (25.2 percent); acute or chronic leukaemia (19.2 percent) and iron deficiency anaemia (10.5 percent). These three diseases respectively accounted for 32 percent, 17.5 percent and 10.8 percent of the cases in the adult (16 years and over) group; whereas in the paediatric (0-15 years) group, the top three diseases were: acute leukaemia (22 percent); Hodgkins and non-Hodgkins lymphomas (14.3 percent) and retinoblastoma (13.7 percent). These preliminary observations indicate some of the commonest haematological and oncological disorders where intense research might be beneficial to the community in Zimbabwe.

Adolescent↗
PubMed1999

Bone marrow examination for identifying malaria in fever of unknown origin.

To determine the utility of bone marrow examination for the diagnosis of malaria in patients with persistent fever for prolonged duration, we prospectively studied individuals undergoing diagnostic bone marrow examinations between January 1992 to December 1996. All marrow examinations of patients were examined microbiologically and resulted in diagnosis of malaria in 6.6% of the total patients studied. No case of bacterial, mycobacterial or fungal infection was diagnosed. The diagnostic efficacy of bone marrow for evidence of malaria was very useful in febrile individuals for whom the diagnosis was otherwise unknown.

Adolescent↗
PubMed1992

Bone marrow examination before steroids in thrombocytopenic purpura or arthritis.

Corticosteroids were used to treat two children with presumed idiopathic thrombocytopenic purpura and one with juvenile rheumatoid arthritis without examination of the bone marrow. Of the two with presumed idiopathic thrombocytopenic purpura, one had Fanconi's anaemia and the other may have had aplastic anaemia. The third child had acute lymphoblastic leukaemia. The diagnosis of Fanconi's anaemia was delayed. A diagnostic and therapeutic dilemma was caused in the second case. In the third, delayed diagnosis and, perhaps, compromised outlook resulted. These three cases re-emphasize the well aired caveats about the diagnosis of idiopathic thrombocytopenic purpura and juvenile rheumatoid arthritis and provide further support for the arguments of those who believe that if corticosteroids are to be used to treat such children, their bone marrow should be examined first.

Arthritis, Juvenile↗
PubMed1989

Bone marrow examination in neuroblastoma patients: a morphologic, immunocytochemical, and immunohistochemical study.

Bone marrow examination was performed at the time of diagnosis, before initiation of therapy, and during follow-up of 14 consecutive patients with neuroblastoma who were treated at the National Hospital in Oslo. A total of 30 bone marrow specimens were examined by conventional histology, by immunohistochemistry with selected monoclonal antibodies to neuroblastoma cells (UJ 13A, UJ 167.11, PI 153/3, and A2B5) applied on trephines, and by morphologic evaluation of smears in addition to immunocytochemistry of aspirated bone marrow cells. The study confirmed the value of immunohistochemistry and immunocytochemistry for the detection of bone marrow involvement in neuroblastoma. Immunohistochemistry performed on bone marrow trephines was a slightly better adjunct than immunocytochemistry on aspirated bone marrow cells.

Adrenal Glands↗
PubMed1994

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.

Biopsy, Needle↗
PubMed1994

Revisited indications for bone marrow examinations in HIV-infected patients.

We reviewed the indications for and the results of bone marrow examination (BME) from HIV-infected patients as an attempt to improve its diagnostic yield. One-hundred-and-eight bone marrow specimens from 90 patients during a 3-year period were examined. A cytological, histological and microbiological study was carried out on the specimens. Forty-three evaluable examinations (40% of total) performed for cytopenia showed normo- or hypercellularity in 33 (77%). Fifty bone marrow specimens were cultured for mycobacteria with a yield of 42% when the indication was persistent fever. Positive cultures yielded Mycobacterium avium complex in 8 out of 12 patients. Twenty-seven patients had both culture and biopsy; granulomas were associated with all the positive (10/10) and with 1 out of 17 negative cultures (chi-square test: p < 0.001). A bone marrow involvement with lymphoma was found in 2 out of 6 patients with previously diagnosed lymphoma, and biopsy revealed a lymphoma in 2 patients. Morphological bone marrow examination should be associated with other techniques in order to appreciate bone marrow production. Bone marrow biopsy is useful for the investigation of persistent fever since granulomas suggestive of disseminated mycobacteria are frequent and allow a treatment to be initiated before microbiological confirmation and antibiotic susceptibility test.

Adolescent↗
PubMed1990

[Bone marrow examination in the horse].

The technique of needle biopsy, the examination of aspirated bone marrow and the interpretation of bone marrow smears are described. The indications for a bone marrow biopsy are listed and the literature is reviewed. The significance of this examination is illustrated with some clinical cases.

Animals↗
PubMed2000

The management of isolated thrombocytopenia in Chinese adults: does bone marrow examination have a role at presentation?

We performed a retrospective analysis of bone marrow examination (BME) in the management of Chinese adult patients less than 60 years of age with isolated thrombocytopenia at presentation. Eighty-three patients with a median age of 39 years presenting with isolated thrombocytopenia (median platelet count: 38 x 10(9)/l) had routinely undergone BME as part of the laboratory investigations during the period from January 1996 to December 1999. All 83 patients had bone marrow findings of active marrow suggesting causes due to peripheral destruction. All of these patients responded to steroid or intravenous immunoglobulin (IVIg) therapy at presentation if their platelet counts were significantly low or if they had mucosal bleeding. Eighty-one of the 83 patients, after a median of 20 months follow-up, were finally diagnosed as having idiopathic thrombocytopenic purpura (ITP). The remaining two patients were finally confirmed as cases of systemic lupus erythematosus (SLE). Our results suggest that BME is not helpful in the diagnosis of isolated thrombocytopenia or suspected ITP in adult patients at presentation, provided that a thorough clinical history and physical examination are undertaken and that the blood count and peripheral blood smear show no abnormalities apart from the thrombocytopenia.

Adolescent↗
PubMed1995

Bone marrow examination in newly diagnosed Hodgkin's disease: current practice in the United Kingdom.

In the UK Hodgkin's disease is usually treated by either clinical oncologists or haematologists. A national study of the performance of bone marrow examination in newly diagnosed Hodgkin's disease was undertaken to establish current practice. A total of 620 questionnaires were despatched, and replies were received from 60% of consultants (45% of clinical oncologists and 70% of haematologists). Bone marrow examination was performed in all new cases significantly more often by haematologists than by clinical oncologists (74% vs 40%, P < 0.001). Among haematologists, there was no correlation between the number of new patients seen annually and practice, however clinical oncologists were even less likely to perform routine bone marrow biopsies if they saw more than ten patients per year (P < 0.02). Where bone marrow examination was performed selectively, the most common criteria used were peripheral blood cytopenia and advanced-stage disease. These criteria were applied in the same way by both clinical oncologists and haematologists. Bone marrow biopsy, an invasive and often painful procedure, is currently performed more frequently in Hodgkin's disease than can be recommended on the basis of recent studies in the literature and associated guidelines. There is a significant difference in practice between clinical oncologists and haematologists, and this raises the wider issue of the influence of hospital specialisation on patient management.

Bone Marrow Examination↗
PubMed2006

Should bone marrow examination be routinely performed for the diagnosis of monoclonal gammopathy of undetermined significance?

BACKGROUND: Monoclonal gammopathy of undetermined significance is defined by the presence of: low serum and/or urine monoclonal protein level; less than 10% plasma cells in bone marrow; normal serum calcium, creatinine and hemoglobinlevels; and no bone lesions on full skeletal X-ray survey. OBJECTIVES: To study the necessity of bone marrow examination for the diagnosis and clinical course of MGUS. METHODS: We retrospectively screened the medical records of all patients in whom monoclonal protein was found in the serum during 2001-2002 in the medical laboratories of Meir Medical Center. Asymptomatic patients who had serum monoclonal immunoglobulin G < 3.0 g/dl or IgA < 2.0 g/dl or IgM < 1.0 g/dl without anemia, renal failure, hypercalcemia or any bone lesions on skeletal survey were eligible. Full records of patients who were evaluated in the hematology clinic were available (group 1). The remaining patients were followed by their family physicians; thus we had access only to their electronic files including laboratory results and new diagnoses (group 2). Demographic and clinical parameters as well as clinical course werewere evaluated. RESULTS: Both groups (57 and 255 patients, respectively) had similar demographic, laboratory and clinical characteristics. Bone marrow examination was performed in 30 of 57 patients (group 1): 16 were normal, 8 had an excess of normal plasma cells, and 6 had excess of pathologic plasma cells. However, only in two of the latter six could a diagnosis of multiple myeloma be established. All group 1 patients were followed for 22 +/- 11 months and onlytwo developed overt multiple myeloma. During the same period, 6 of 255 patients (group 2) were diagnosed as multiple myeloma and 3 as MGUS in other hospitals. The rest had a stable course with no change in their laboratory values. CONCLUSIONS: Our findings suggest that bone marrow examination should not be performed routinely in patients who fulfill strict clinical and laboratory criteria of MGUS.

Aged↗
PubMed2000

Bone marrow examination for primary diagnosis and follow-up in patients with lymphoproliferative disorders. An overview with emphasize on bone marrow histology.

The aim of his overview is to provide some insight into the manifold applications of bone marrow examination in lymphoproliferative disease. Having a large selection of methods any clinician working in this field should be familiar with the diagnostic relevance of each method for a given diagnostic problem. The choice of the appropriate investigations will warrant a correct diagnosis and helps to lower health expenses. Because of the multiplicity of the methods, often performed at different institutions, a lot of confusion can be caused by conflicting interpretation of isolated results. A diagnosis should never be based on isolated findings such as immunophenotyping or demonstration of a clonal population. Results of various investigations are to be integrated into a final diagnostic concept, which will be the basis for therapeutic decisions.

Biopsy↗
PubMed1994

[Prognostic value of bone marrow examinations on day 8 and day 17 of the first induction therapy cycle in acute myeloid leukemia].

Bone marrow examination yields valuable diagnostic information for evaluation of treatment efficacy in acute myelogenous leukemia (AML) patients. However, the ideal timing of this procedure remains to be defined. Usually the first follow-up examination is performed on day 17 of the induction course. Since an earlier analysis might be helpful in deciding on the subsequent treatment strategy, we explored whether an examination on day 8 might be equivalent, in particular in terms of quality of the specimen, as compared with that on day 17. In 10 AML patients undergoing the same induction treatment, bone marrow aspirates were examined prospectively at diagnosis (day 0), immediately after termination (day 8) and on day 17 of the first treatment course. We found that the number of cells not classifiable due to artifacts, as well as the otherwise non-evaluable cells, did not differ significantly in aspirates obtained on day 8 as compared with those on day 17. The number of leukemic cells decreased significantly from day 0 to day 8, whereas no change was noted between days 8 and 17. We conclude that a marrow examination on day 8 is not more prone to misinterpretation due to artifacts than our standard examination on day 17. Thus, an early marrow analysis immediately after completion of the first induction cycle might be a helpful tool in evaluating course of AML.

Adult↗