Bone marrow aspiration cytology in Abubakar Tafawa Balewa University Teaching Hospital, Bauchi State, Nigeria: Indications and diagnostic utility

Abstract

Bone Marrow Aspiration (BMA) cytology is an important diagnostic and monitoring tool where cytological details of the marrow elements are examined using light microscopy. Various hematological diseases are diagnosed and monitored by using BMA. This study aimed at reporting a 3-year BMA experience of Department of Hematology and Blood Transfusion of Abubakar Tafawa Balewa University Teaching Hospital (ATBUTH) Bauchi. This was a retrospective study that involved the use of records of the bone marrow aspirates done from January 1st, 2016 to December 31st, 2018. The age, sex, indications for BMA, anatomical site and final bone marrow diagnosis were collated. The data was analyzed using SPSS Version 23.0 software. One hundred and three (103) bone marrow aspirations were performed during the period under review. Two third of the participants were males, with the median age of 40.0 years and a range of 5 months to 92 years. The commonest indication for BMA was recurrent anemia 45.6%, followed by splenomegaly, fever and lymphadenopathy with 11.7% each. While, the commonest diagnosis by BMA was megaloblastic anemia (28.2%). Mixed nutritional deficiency and Bone Marrow (BM) metastasis are the commoner BMA diagnoses with 12.6% each. Recurrent anemia is the commonest indication for BMA and nutritional anemias (megaloblastic and combined nutrients deficiency) are the commonest BMA diagnoses in Bauchi. Proper evaluation of patients by the clinicians before referral is recommended to ensure that only those that really need the procedure are subjected to it.

Diagnostic Outcome of Bone Marrow Aspiration in a Tertiary Hospital in Ondo State, Nigeria

“…A larger number of our patients were male with a male-female ratio of 1:0.7. This is similar to study done by Dachi et al, with a larger percentage of patients known to be male [16], reports in India by Khan et al, also shows dominance of male which is in correlation with our study [17]. Majority of the BMA were done on in-patient basis which is similar to study done by Adewoyin et al in Benin City showing that most of the patient's symptoms and management required hospitalization [18].…”

“…The most common indications for BMA cytology in our study is Anaemia with majority of the patients with Moderate anaemia. This is similar to the studies done by Damulak et al [15] in Jos, Awwalu et al, in Zaria [21] and also Dachi et al, in Bauchi [16]. Large percentage of anaemia seen in our patients may be due to late presentation at the hospital caused by lack of funds, ignorance and patients patronizing private hospitals where further investigations are not done to find out the cause of anemia.…”

“…Megaloblastic anemia and Multiple myeloma were the second most common diagnostic findings seen in our study. This is in conflict with study by Dachi et al which shows MA was the most common diagnostic findings in BMA [16]. The high predominance of MA could be traced to the standard of living of the patients with most of them having to overcook their food most especially vegetables containing folates.…”

“…This was supported in a study by Pierini et al, which a higher concentration and yield of colony-founding connective-tissue progenitors were greater when aspirate was obtained from the posterior compared with the anterior iliac crest [23] Lesser number of aspirates were taken from the sternum mostly in the obese patients by well-trained expertise due to the deadly risk of damage to the underlying structures such as heart and major vessels [24]. However, our study is in contrast with that done in Bauchi that reported right anterior iliac spine as the major site of bone marrow aspiration (45.6%) [16].…”