Bone marrow examination at a paediatric hospital in Kenya

Abstract

Objective: To investigate the main indications for, and common conditions found in bone marrow examinations (BME) of children.

Methods: This was a retrospective study from September 1, 1993 to September 3 1998. All bone marrow aspirate and trephine biopsy results were retrieved. The clinical data provided by clinicians were also noted.

Results: A total of 97 BME were recorded from patients aged two months to 13 years. The peak ages for BME were six to eight years (24% of patients). The more frequent indications for BME were unexplained anaemia found in 26% request forms, investigation for solid tumours (10%) and lymphoma (10%) and remission assessment after treatment for leukaemia (26%). The main findings were malignancy (27%) with leukaemia being commonest (ALL) 16% of patients and acute myeloblastic leukaemia (5%). Haematinic deficiency was seen in 12.7% of cases with iron deficiency being the commonest. There were some notable differences and similarities in the study as compared to a similar one performed at a local referral hospital.

Conclusion: The importance of BME as a crucial investigational tool in the management of patients is underscored. Interpretation is more meaningful when the haematologist has adequate clinical data.