Prediction of Bone Marrow Cellularity from Aspiration as compared to Trephine Biopsy

Abstract

Background: Bone marrow cellularity is an essential and integral part of the bone marrow examination report. Cellularity could be obtained from both bone marrow aspirations and biopsies. Predicting marrow cellularity from aspiration as opposed to biopsy would give the clinician the convenience of an early diagnosis and timely management. In this study, we aimed at knowing the degree of correlation between the bone marrow aspiration cellularity that could be ready within a short period of time to that of bone marrow biopsy cellularity that could take days to have a positive impact on the management, especially for acute blood disorders. Materials and Methods: We collected 200 consecutive bone marrow aspirations from the Nanakaly Teaching Hospital. All the bone marrow biopsy slides belonging to the same group of patients were also collected from the main histology center at Rizgary Teaching Hospital. Five expert hematopathologists were given the chance to report on the cellularity for both the aspirations and the biopsies. The study was performed in sessions, limiting each session to 20 aspirations and 20 biopsies. Cellularity was rated in percentage points of 5 giving the observer the chance to rate the cellularity from 0% to 100%. Results: Microsoft Excel spreadsheet was used to record all the data obtained from the observers. Mean values from all the five observers for each aspiration and biopsy was used for statistical analysis. We found a strong direct positive correlation between the bone marrow biopsy cellularity and bone marrow aspiration cellularity. Conclusion: A simple practical equation could be created to measure bone marrow biopsy cellularity from the usually available aspiration cellularity. Marrow biopsy cellularity was found to be 0.96 of the aspiration cellularity.