Bone-marrow spectrum in a tertiary care hospital: Clinical indications, peripheral smear correlation and diagnostic value

Aim: The aim was to identify the indications for a bone-marrow aspiration study, to correlate between peripheral blood smear findings and those of bone-marrow aspiration; and to assess the diagnostic value of bone-marrow aspiration examination. Settings and Design: A retrospective study was done on patients referred for bone-marrow aspiration in a tertiary care hospital for a period of about 3 years. Materials and Methods: Stained bone-marrow aspirate smears were examined. Records regarding the clinical indication for the procedure, peripheral blood smear reports, blood counts and significant findings on bone-marrow aspiration examination were retrieved. The role of bone-marrow aspiration in the diagnosis of hematological and nonhematological disorders was reviewed in the study. Results: Of a total of 153 cases, 24 (15.68%) were from the pediatric age group and 129 (84.32%) were adults. Male:female ratio was 1.3:1. The indications were anemia for evaluation (33%), evaluation of pancytopenia (26%), suspicion of malignancy (17%), fever (10%) and thrombocytopenia (3%). Bone-marrow aspiration yielded a diagnosis of hematological malignancy in a total of 11 cases. However, peripheral blood smear examination was able to pick up only seven of these cases. Furthermore, one case of metastatic deposits was seen in a case of carcinoma of unknown primary. The bone-marrow findings correlated with the peripheral blood smear findings in 54 (43.2%) out of 125 of the total cases. Conclusion: This study shows that bone-marrow aspiration is a valuable diagnostic tool and aids in diagnoses and etiology of various hematological findings such as anemia and pancytopenia.