List the indications for a bone marrow biopsy. What investigations can be collected from a bone marrow aspirate and biopsy?
Indications for a bone marrow biopsy:
- Evaluation of anemia or a cytopenia NYD
- Staging for lymphoproliferative disorders
- Diagnosis of hematologic malignancies including AML, myeloma, MDS, and MPNs
- Gold standard for evaluation of iron stores
- Evaluation of other diseases (i.e. macrophage activation syndrome, storage disease) or infections
Distinguish the differences of an aspirate compared to a biopsy.
| Investigation | Bone Marrow Aspirate | Bone Marrow Biopsy |
| Cytology | Ensure spicules in collection
Allows assessment of bone marrow cellularity and cytology of cells |
Preferred 2cm length of biopsy
Assesses bony architecture |
| Flow cytometry | Allows for evaluation of diagnosis and clonality re identification of CD markers (i.e. in leukemias and lymphomas) | Not routinely done on a biopsy specimen
Can try to obtain if separate biopsy specimen is placed in a sterile medium More common: Perform immunohistochemistry stains on biopsy material |
| Cytogenetics | Evaluate chromosomal aberrations (i.e. deletions, translocations)
Imperative to be collected for AML, ALL, CML, CLL, MM, MDS, and certain lymphoproliferative disorders |
Can try to obtain if a separate biopsy specimen is placed in a sterile medium |
| Molecular studies | PCR based testing
Must be collected in suspected cases of acute leukemia, CML, and myeloproliferative neoplasms |
Can try to obtain if a separate biopsy specimen is placed in a sterile medium |
