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. 2004 Oct;57(10):1038-40.
doi: 10.1136/jcp.2003.015834.

How should stainable iron in bone marrow films be assessed?

D A Hughes  1 , S E Stuart-Smith, B J Bain
Affiliations

How should stainable iron in bone marrow films be assessed?

D A Hughes et al. J Clin Pathol. 2004 Oct.

Abstract

Aims: To identify how many particles should be examined to enable a confident assessment of the presence or absence of iron stores and the quantity of iron in a bone marrow aspirate to be made.

Methods: One hundred and ninety consecutive bone marrow aspirate samples were stained with Perls' stain and the iron content of 10 consecutive particles was recorded. The first particle found to be positive and the particle that was most positive were also noted.

Results: A minimum of seven particles must be examined to establish the absence of stainable iron. A minimum of nine particles must be reviewed to see the maximum iron stores in 100% of samples and therefore make a valid judgment of whether iron stores are reduced, normal, or increased. By these criteria, 46% of the samples tested here could not be optimally assessed for absence of iron or maximum iron stores.

Conclusions: The sensitivity of examination of bone marrow aspirates for iron stores can be optimised by increasing the number of particles reviewed to seven or more. This may require the staining of additional slides.

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Figures

Figure 1
Figure 1
Distribution of particle numbers in 190 consecutive bone marrow aspirates examined. Eighty seven (45.7%) had 10 or more particles, 43 (22.6%) had no particles, and 60 (31.5%) had between one and 10 particles.
Figure 2
Figure 2
Percentage of patients with one or more particles positive for iron after examining one to 10 particles.
Figure 3
Figure 3
Percentage of patients with one or more particles showing maximal positivity for iron after examining one to 10 particles; maximal positivity indicates the maximal positivity seen in a particular patient.
See this image and copyright information in PMC

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