Original Research

Diagnostic outcomes of bone marrow aspirate and trephine biopsies performed at a hospital in KwaZulu-Natal, South Africa

Wanda S. Tshabalala, Somasundram Pillay, Doughlas P.K. Wilson
African Journal of Laboratory Medicine | Vol 9, No 1 | a1028 | DOI: https://doi.org/10.4102/ajlm.v9i1.1028 | © 2020 Wanda S. Tshabalala, Somasundram Pillay, Douglas P.K. Wilson | This work is licensed under CC Attribution 4.0
Submitted: 12 April 2019 | Published: 25 February 2020

About the author(s)

Wanda S. Tshabalala, Department of Internal Medicine, Grey’s Hospital, University of KwaZulu-Natal, Pietermaritzburg, South Africa
Somasundram Pillay, Department of Internal Medicine, Edendale Hospital, Pietermaritzburg complex, University of KwaZulu-Natal, Pietermaritzburg, South Africa
Doughlas P.K. Wilson, Department of Internal Medicine, Edendale Hospital, Pietermaritzburg complex, University of KwaZulu-Natal, Pietermaritzburg, South Africa


Share this article

Bookmark and Share

Abstract

Background: Bone marrow aspiration and trephine biopsy (BMAT) are widely performed in adults to evaluate haematological and malignant conditions. However, the diagnostic yield from the procedure in unselected patients in the South African public sector has not previously been described.

Objectives: We identified the main indications and most common diagnoses encountered for BMAT and described the demographic and blood profiles of patients, including HIV-positive patients, who had undergone the procedure at a tertiary hospital in KwaZulu-Natal.

Methods: We retrospectively reviewed laboratory data from January 2016 to December 2016 for all patients aged ≥ 13 years who underwent the procedure and stratified findings by demographic data.

Results: Among 120 BMAT biopsies studied, 80 (67%) cases were performed to evaluate suspected malignancy and a further 40 (33%) cases for non-malignant indications. The main indications for bone marrow examination were: cytopenias 38 (32%), lymphoma 35 (29%), leukaemia 21 (18%), and multiple myeloma 17 (14%). BMAT results revealed that 60 cases (50%) were malignant in origin, 30 cases (25%) were non-malignant and 30 cases (25%) were classified as normal. The common diagnoses were: leukaemia, 24 (20%); multiple myeloma, 16 (13%) and lymphoma, 13 (11%). Cases aged ≥ 50 years were more likely to have a malignant diagnosis (odds ratio: 5.8 (95% confidence interval: 2.2–17.1) p-value < 0.001).

Conclusion: The diagnostic yield of BMAT was high, with significant abnormalities detected in three quarters of cases. Haematological malignancy was the more common diagnosis. Increasing age was associated with an increase in reporting of haematology malignancy.


Keywords

age; human immune virus; indications; outcomes; haematological malignant diseases; diffuse large B cell lymphoma; bone marrow aspirate and trephine biopsy

Metrics

Total abstract views: 542
Total article views: 383


Crossref Citations

No related citations found.