Bone Marrow Examination in Elderly Patients at Tribhuwan University Teaching Hospital.
Abstract
Introduction: Bone marrow examination is an
important investigation for diagnosis of hematological
and nonhematological disorders. There is an increase
in the elderly population and frequency of diseases
among them for which bone marrow examination is
indicated. Hence, bone marrow examination in elderly
population requires special attention.To evaluate bone
marrow findings in elderly patients (65 years of age
and above) at a tertiary care hospital.
Materials and methods: This was a hospital-based,
observational, cross-sectional study of elderly
patients undergoing bone marrow examination at
the department of pathology, Tribhuwan University
Teaching hospital from May 2018 to April 2019.
Morphology of bone marrow aspiration and biopsy
were studied in these cases and correlated with clinical
and other ancillary laboratory tests parameters.
Results: The most common indication of bone
marrow examination was pancytopenia (23.72%)
followed by suspected plasma cell neoplasm
(23%) and suspected acute leukemia (16%). AML
(15%) was the most common neoplastic disorder
followed by myeloproliferative neoplasm (13.6%),
myelodysplastic syndrome (10%) and multiple
myeloma (8%). Anemia due to renal failure (8%) was
the most common non neoplastic disorder followed
by megaloblastic anemia and anemia of chronic
inflammation (5% each).
Conclusion: Neoplastic disorders were more common
than nonneoplastic and hematological malignancies
were the most common diagnosis. Bone marrow
examination alone was able to yield specific diagnosis
in the majority of cases. The diagnostic yield of bone
marrowexamination increased further by correlating
bone marrow findings with clinical parameters and
other ancillary tests.