Bone marrow biopsy morbidity: review of 2003: Table 1

Abstract

Background:Although some hazards are recognised, in general, bone marrow aspiration and trephine biopsy are thought to be safe procedures. Until recently, no attempt had been made to quantify any attendant risks. For this reason, documentation of adverse events was begun in 2001, under the auspices of the British Society for Haematology. Three consecutive years have now been surveyed, the results for 2003 being presented here and compared with earlier results.Methods:Members of the British Society of Haematology were requested to document adverse events associated with diagnostic bone marrow aspirates and trephine biopsies between 1 January and 31 December, 2003. Data were collected early in 2004.Results:In total, 19 259 procedures were reported from 63 hospitals, 13 147 being combined procedures and 6112 aspirates without a trephine biopsy. Sixteen adverse events were reported, representing 0.08% of total reported procedures. The major adverse event was haemorrhage, which comprised 11 of the 16 adverse events. Although infrequent, adverse events were associated with significant morbidity and three were judged as very serious. The major risk factors for haemorrhage, in order of frequency, were diagnosis of a myeloproliferative disorder, aspirin treatment, other putative platelet dysfunctions, and thrombocytopenia.Conclusions:Adverse events following trephine biopsies and bone marrow aspirates are rare, but nevertheless can have considerable impact on individual patients.

The role of bone marrow biopsy and FDG‐PET/CT in identifying bone marrow infiltration in the initial diagnosis of high grade non‐Hodgkin B‐cell lymphoma and Hodgkin lymphoma. accuracy in a multicenter series of 372 patients

“…Since the seventies and until very recently, trephine bone marrow biopsy (BMB) has been considered the gold standard procedure in assessing bone marrow status, in spite of its clear shortcomings in terms of low sensitivity, procedural anxiety and pain, and other more relevant although less frequent complications (i.e., bleeding, impaired ambulation, and fractures at the site of the biopsy) [3,4].…”

Sciatic Nerve Neuropathy Developed After Bone Marrow Aspiration in the Pediatric Patient

“…Kemik iliği aspirasyonu, yirminci yüzyılın başla-rından itibaren kullanılmaya başlanmış olup, çoğunlukla sternum veya posterior iliak krestten uygulanan hematolojik hastalıklar için önemli bir tanı aracıdır (4). Genellikle güvenli bir yöntem olarak kabul edilen kemik iliği aspirasyonun yan etki sıklığı bir çalışmaya göre %0,08 olup, miyeloproliferatif hastalık, aspirin kullanımı, trombosit disfonksiyonu ve trombositopeni varlığında bu risk artmaktadır (5).…”

“…vasküler nedenler (7), gluteal bölgeye yapılan enjeksiyonlar (8) ve viral enfeksiyonlar sayılabilir (3). Kemik iliği aspirasyonu sonrası oluşan komplikasyonlar hemorajiye bağlı olup, bu durum en sık olarak miyeloproliferatif hastalık varlığında gerçekleşmektedir (5). Bizim vakamızda da kemik iliği aspirasyonu sonuçları miyelodisplazi ile uyumlu idi.…”

Reply:

“…1 MHE is a neurocognitive complication of cirrhosis which is associated with poor quality of life, increased rate of progression to overt hepatic encephalopathy (OHE) and driving skill impairment. [2][3][4][5][6] MHE detection is not possible by clinical examination but can only be performed using neuropsychometric/neurophysiological techniques, as in the paper by Kale et al 1,[7][8][9] We set out to determine the diagnostic approaches of U.S.-based members of AASLD toward MHE systematically to identify potential barriers to routine testing. An anonymous questionnaire querying the practice profile, personal opinions regarding MHE diagnostic strategies, fre-…”

“…The adverse events associated with BM biopsy are rare (about 1 per 1000 procedures) but can be serious; moreover, diagnosis of CMD is a risk factor for hemorrhagic complications even in the absence of antiplatelet agents. 8 Finally, most of the PVT patients are on anticoagulant therapy, so that biopsy needs special care. Therefore, the indication to BM biopsy in this particular setting should be balanced with the clinical utility and to the likelihood that the procedure will modify treatment.…”