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.