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. 2018 Oct 1;150(5):393-405.
doi: 10.1093/ajcp/aqy066.

Trends in Bone Marrow Sampling and Core Biopsy Specimen Adequacy in the United States and Canada: A Multicenter Study

Mihai Merzianu  1 , Adrienne Groman  2 , Alan Hutson  2 , Claudiu Cotta  3 , Russell K Brynes  4 , Attilio Orazi  5 , Vishnu Reddy  6 , Julie Teruya-Feldstein  7 , Ramila Amre  8 , Manjula Balasubramanian  9 , Guilherme Brandao  10 , Sindhu Cherian  11 , Elizabeth Courville  12 , David Czuchlewski  13 , Guang Fan  14 , David Grier  15 , Daniela Hoehn  16 , Kedar V Inamdar  17 , Ridas Juskevicius  18 , Prabhjot Kaur  19 , John Lazarchick  20 , Michael R Lewis  21 , Rodney R Miles  22 , Jerome B Myers  23 , Michel R Nasr  24 , Hina N Qureishi  25 , Horatiu Olteanu  26 , Valentin G Robu  27 , Gratian Salaru  28 , Neerja Vajpayee  29 , Jeffrey Vos  30 , Ling Zhang  31 , Shanxiang Zhang  32 , Le Aye  4 , Elisa Brega  10 , James E Coad  30 , John Grantham  30 , Sinisa Ivelja  33 , Robert McKenna  12 , Kieran Sultan  24 , Gregory Wilding  2 , Robert Hutchison  29 , LoAnn Peterson  34 , Richard T Cheney  35
Affiliations

Trends in Bone Marrow Sampling and Core Biopsy Specimen Adequacy in the United States and Canada: A Multicenter Study

Mihai Merzianu et al. Am J Clin Pathol. .

Abstract

Objectives: To assess bone marrow (BM) sampling in academic medical centers.

Methods: Data from 6,374 BM samples obtained in 32 centers in 2001 and 2011, including core length (CL), were analyzed.

Results: BM included a biopsy (BMB; 93%) specimen, aspirate (BMA; 92%) specimen, or both (83%). The median (SD) CL was 12 (8.5) mm, and evaluable marrow was 9 (7.6) mm. Tissue contraction due to processing was 15%. BMB specimens were longer in adults younger than 60 years, men, and bilateral, staging, and baseline samples. Only 4% of BMB and 2% of BMB/BMA samples were deemed inadequate for diagnosis. BM for plasma cell dyscrasias, nonphysician operators, and ancillary studies usage increased, while bilateral sampling decreased over the decade. BM-related quality assurance programs are infrequent.

Conclusions: CL is shorter than recommended and varies with patient age and sex, clinical circumstances, and center experience. While pathologists render diagnoses on most cases irrespective of CL, BMB yield improvement is desirable.

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Figures

Figure 1
Figure 1
Clinical indications for bone marrow biopsy (A) and rendered pathologic diagnoses (B). CLL/SLL, chronic lymphocytic leukemia/small lymphocytic lymphoma.
Figure 2
Figure 2
Changes in bone marrow clinical and laboratory practice between 2001 and 2011 in 32 participating centers.
Figure 3
Figure 3
Overall (A, B) and separate for 2001 and 2011 (C, D) postprocessing and evaluable marrow core length measurements in 32 participating centers (diamond, mean; line, median; bar, range; box, quartiles 1 to 3, values in millimeters).
Figure 3
Figure 3
Overall (A, B) and separate for 2001 and 2011 (C, D) postprocessing and evaluable marrow core length measurements in 32 participating centers (diamond, mean; line, median; bar, range; box, quartiles 1 to 3, values in millimeters).
Figure 4
Figure 4
Distribution of samples involved by lymphoma relative to core biopsy specimen length.
See this image and copyright information in PMC

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