From the Guidelines
Bone marrow pathology provides critical information about the cellular composition and health of the bone marrow, which is essential for diagnosing various hematological disorders, including the quantity, maturity, and morphology of blood cell precursors, cellularity, iron stores, fibrosis, and the presence of abnormal cells or infectious organisms. A bone marrow examination can identify abnormal cells such as leukemic blasts, dysplastic cells, or infiltrating cancer cells from other tissues. The pathology also evaluates the overall cellularity of the marrow compared to fat content, which is crucial for diagnosing conditions such as myelodysplastic syndromes, myeloproliferative disorders, and aplastic anemia 1. Special stains and techniques like flow cytometry, cytogenetics, and molecular testing provide additional information about cell markers, chromosomal abnormalities, and genetic mutations, which can help diagnose conditions including leukemias, lymphomas, multiple myeloma, and metastatic cancers 1. This comprehensive analysis is particularly valuable because it provides direct visualization of the hematopoietic environment, offering insights that peripheral blood tests alone cannot provide, making it an essential tool for hematologists and oncologists in treatment planning and monitoring disease progression 1. Some of the key information that bone marrow pathology can show includes:
- The presence of dysplastic cells or leukemic blasts
- The cellularity of the marrow and the presence of fibrosis
- The presence of granulomas or infectious organisms
- The quantity and morphology of blood cell precursors, including red blood cells, white blood cells, and platelets
- The presence of chromosomal abnormalities or genetic mutations
- The presence of metastatic cancer cells from other tissues. Bone marrow pathology is a crucial diagnostic tool that can provide valuable information for the diagnosis and treatment of various hematological disorders, and it is strongly recommended to perform bone marrow biopsy at diagnosis to assess cellularity and fibrosis, especially to exclude other causes of cytopaenia and because of its potential prognostic information 1.
From the FDA Drug Label
Facilities should be available for management of complications, possibly fatal, of bone marrow suppression Bone marrow examinations should be performed frequently after blasts have disappeared from the peripheral blood. The bone marrow pathology shows bone marrow suppression, including granulocytopenia and thrombocytopenia, as well as the presence or absence of blasts in the peripheral blood.
- Bone marrow examinations are used to monitor the effects of cytarabine on the bone marrow.
- The results of bone marrow pathology are used to determine when to restart therapy after it has been suspended due to bone marrow depression 2.
- Frequent bone marrow studies are necessary to assess marrow recovery 2.
From the Research
Bone Marrow Pathology Information
Bone marrow pathology can show various information from a bone marrow sample, including:
- Morphological evaluation of the bone marrow aspirate and biopsy 3
- Diagnosis and follow-up of hematological disorders such as megaloblastic hemopathy, multiple myeloma, and chronic lymphocytic leukemia 4
- Sensitivity to diagnose hemopathies and possibility of morphological evaluation and anatomopathological study 4
- Antigenic expression in immunohistochemical and FISH techniques 4
- Flow cytometric examination, cytochemical stains, cytogenetic and molecular analysis 5
Diagnostic Techniques
Different diagnostic techniques can be performed on bone marrow aspirate material, including:
- Flow cytometric examination 5
- Cytochemical stains 5
- Cytogenetic and molecular analysis 5
- Immunocytochemistry 3
- Immunoperoxidase or other techniques on sections prepared from the bone marrow biopsy 5
Interpretation of Results
The interpretation of bone marrow specimens and the use of ancillary techniques are crucial for therapeutic monitoring and planning optimal therapy 3. The pathologist's report of marrow samples can provide information on: