4 Global Journal of Hematology and Blood Transfusion, 2015, 2, 4-8
E-ISSN: 2408-9877/15 © 2015 Cosmos Scholars Publishing House
Indications and Spectrum of Haematological Disorders from Bone
Marrow Aspiration Examination: A Three Year Review Study
Timothy Amos Ekwere
1,*
, Mabel Benson Ino-Ekanem
1
and Olugbemi Oluseyi Motilewa
2
1
Department of Haematology University of Uyo/University of Uyo Teaching Hospital, Uyo, Akwa-Ibom State,
Nigeria
2
Department of Community Health University of Uyo/University of Uyo Teaching Hospital, Uyo, Akwa-Ibom
State, Nigeria
Abstract: Background: Haematological disorders have diverse modes of presentation that often requires bone marrow
examination for both diagnosis and management. This simple and relatively safe procedure is important particularly in
resource poor centres since access to adjuvant diagnostic techniques are often lacking or absent. This study was
conducted to determine the indications and the spectrum of Haematological diseases diagnosed using this procedure.
Methodology: This was a retrospective study conducted in the Department of Haematology University of Uyo Teaching
Hospital from January 2011 to December 2013. Bone marrow aspiration cytology records of 62 suspected cases of
haematological diseases were reviewed and analyzed using STATA software version 10.
Results: Majority of the patients who had bone marrow aspiration were adults aged 19 years and above. The male to
female ratio was 1.2:1. Most (93.5%) of the marrow aspirate examined had definitive pathologic features while 4 (6.5%)
were normal marrow elements. The main indications for BMA examination in order of decreasing frequency include;
anaemia (37.1%), diagnosis of Leukaemia (30.7%) and pancytopaenia (5.1%). Acute leukaemia was the most common
haematological disease diagnosed using this procedure. Acute myeloid leukaemia was twice as common as acute
lymphoblastic leukaemia. Also, mixed nutritional deficiencies occurred more commonly than single nutrient deficiency.
Conclusion: The indications for BMA examination in this study are similar to those reported in other studies. This
procedure remains a veritable tool in the diagnosis and management of a wide range of haematological diseases
especially in a resource poor centre like ours.
Keywords: Anaemia, Bone marrow aspiration cytology, Biopsy, Leukaemia.
INTRODUCTION
Bone marrow examination is an important
diagnostic tool in haematology. It is a simple and
relatively safe procedure carried out routinely in
hospitals for the diagnosis and management of
haematological and to some extent non-haematological
disorders. In addition, the procedure may be necessary
in staging, prognostication and evaluation of
therapeutic response in some disorders [1].
A normal bone marrow consists of stem cells which
are largely primitive undifferentiated cells that are
supported by fibrous tissues called stroma. Bone
marrow can be one of two types, red or yellow marrow
depending on whether it consists mainly of
haemopoietic tissues or fatty tissues respectively.
Progressive differentiation and maturation of the
primitive stem cells results in specific marrow cell type
i.e. Leucocytes, Erythrocytes and Platelets [2].
Diseases affecting the bone marrow may be primary or
a secondary spread to the marrow. In both cases the
*
Address correspondence to this author at the Department of Haematology
University of Uyo/University of Uyo Teaching Hospital, Uyo, Akwa-Ibom State,
Nigeria; Tel: 234-803-579-1835;
E-mail: timothyekwere@yahoo.com
normal marrow cellular architecture is distorted.
Anaemia is a common presentation in most of these
diseases whether haematological or otherwise. Hence,
a detailed description of the morphology of the marrow
elements may provide sufficient explanation for
unexplained cytopaenias, leukaemia, and other
haematological disorders including metastases to the
bone marrow [1].
Various studies have identified different indications
for bone marrow examination. A study by Bashawri LA,
identified pancytopaenia, leukaemia, staging of
lymphoma among others as the major indications for
bone marrow aspiration [3]. In a similar study in
Nigeria, Egesie et al, identified anaemia as a major
indication for BMA [4].
Therefore, the aims of this current study are to
identify the common indications for BMA cytology and
the spectrum of Haematological disorders commonly
diagnosed using this procedure.
METHODOLOGY
Study Site
The study was conducted at University of Uyo
Teaching Hospital (UUTH), a specialist referral