Bone M arrow Cellularity Determination : Comparison of the Biopsy

Bone marrow biopsies ( 244) performed buffy coat. The greatest variance was seen with a Jamshidi needle were evaluated in the hypercellular or normocellular marin 53 children with leukemia or aplastic rows, as estimated by biopsy, in which anemia. Adequate specimens were ob39% were misinterpreted as moderately tamed in 85%. Results of cellularity estior severely hypocellular by aspirate. Volmated by biopsy were compared to the umetric measurement of buffy coat was cellularity of the aspirate versus volumetleast acceptable for estimating cellularity. nc determination of the myeloid-erythroid Thus the biopsy has proved to be an imlayer ( buffy coat) . A wide discrepancy was portant and reliable indicator of bone marnoted between marrow cellularity conrow cellularity. firmed by biopsy versus the aspirate or T HE ESTIMATE OF CELLULARITY OF THE BONE MARROW in patients with leukemia and aplastic anemia is important in following the clinical course of these diseases and in evaluating their responses to therapy. Cellularity of marrow has routinely been estimated by a variety of means. Examination of aspirate “smears” or measurement of the myeloid-erythroid layer (buffy coat) as a percentage of the total volume (volumetric method) are the most widely used methods.’ Both of these methods have the disadvantage that aspirated material is a mixture of marrow and sinusoidal blood and thus may not accurately reflect true cellularity of the marrow. The introduction of a new biopsy needle by Jamshidi and Swaim has provided an instrument capable of easily obtaining bone marrow biopsies with little or no more discomfort than a routine aspiration. In addition, with this needle, a sample of marrow of adequate size and minimal destruction of structure can be obtained, which allows an accurate interpretation of the cellularity of the marrow and architectural characteristics.2’3 A comparison of the cellularity by this needle biopsy versus the aspirate (“fleck”) and buffy coat has not heretofore been recorded. The purpose of this report is to compare these three methods of determining marrow cellularity in children with leukemia or aplastic anemia.