Clinical significance of bone marrow smear and bone marrow biopsy in the diagnosis of myelodysplastic syndrome

Objective To explore the value of bone marrow smear and bone marrow biopsy in the diagnosis of myelodysplastic syndrome(MDS) for correcting the classification and guiding the treatment.Methods The morphological characteristics of bone marrow smear and bone marrow biopsy of 64 patients with MDS were observed and compared.Results Using bone marrow smear,the dysplasia of granulocytic line,erythrocytic line and megakaryocytic line were found in 57 cases(89.1%),40 cases(62.5%) and 23 cases(35.9%),respectively.The percentage of primitive cells was less than 5% in 29 cases,5%-9% in 18 cases and 10%-19% in 17 cases.By biopsy,abnormal localization of immature precursor was found in 55 cases(85.9%),the dysplasia of megakaryocytic line in 39 cases(60.9%),Gomori-positive staining in 23 cases(35.9%),including 13 cases of myelofibrosis(20.3%),and iron-positive in 39 cases(60.9%).Conclusion Bone marrow smear can show the pathological changes from the cell morphology and microstructures.While biopsy not only fully display the structures among hematopoietic cells,and the adjacent connection with trabecular bone and the interstitial cells,but also reflect the bone marrow fibrosis and the abnormalities of iron metabolism.Bone marrow smear and biopsy slice have their own advantages in the diagnosis and classification of MDS.Combined detection can fully reflect morphological changes of bone marrow in patients with MDS and improve the accuracy of diagnosis.