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Introduction: Lymphoma constituting 55.6% of hematological malignancy, its prognosis depends on thecorrect diagnosis and stage of the disease, which is established after examination of peripheral blood film(PBF), bone marrow aspir...
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Introduction: Lymphoma constituting 55.6% of hematological malignancy, its prognosis depends on thecorrect diagnosis and stage of the disease, which is established after examination of peripheral blood film(PBF), bone marrow aspiration (BMA) and bone marrow biopsy (BMB) along with other parameters.Objective: The objective is to find out the percentage and pattern of bone marrow involvement, along withperipheral blood changes in lymphoma.Material and Methods: PBF, BMA and BMB findings studied in 60 lymphoma patients during a periodof 3 years. The PBF and aspiration smears stained with Leishmann’s stain, while the trephine biopsyprocessed and stained with Haematoxylin and eosin (H & E) stain and Reticulin stain. The results werescrutinized, compared and evaluated.Results: The male to female ratio was 1.4:1, including 53(88.3%) cases of NHL and 7(11.7%) casesof HL. Most common age group involved in NHL was 51-60 years and in HL was 31-40 years. 19/60(31.7%) cases showed leucocytic lymphocytosis on PBF examination. Percentage lymphocytes in marrowdifferential count was increased in 16(26.7%) cases and were reported with bone marrow involvementon BMA and BMB and 1 case having borderline percentage lymphocyte count on BMA was reported asbone marrow involved case, only after examining the BMB. The diffuse pattern of involvement was mostcommon in 7(41.2%), followed by paratrabecular pattern in 6(35.3%) cases.Conclusion: Thus to conclude bone marrow examination give valuable information in lymphoma, aboutdisease burden, percentage of involvement, pattern of involvement and baseline involvement prior totherapy.
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Lymphomatous infiltrates are most commonly encountered in a bone marrow biopsy (BMB) taken for lymphoma staging or for diagnosis of a suspected haematological abnormality. Crucial for staging, the BMB may show classic and variant ...
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Lymphomatous infiltrates are most commonly encountered in a bone marrow biopsy (BMB) taken for lymphoma staging or for diagnosis of a suspected haematological abnormality. Crucial for staging, the BMB may show classic and variant patterns of lymphomatous infiltration and immunoprofile. Exceptions to the common profiles may be associated with variant cytogenetics and have prognostic implications. Diagnosis should be multifaceted and flow cytometry and molecular studies may be required to arrive at a final diagnosis. Assessment of haematopoiesis should be included in all reports.In follow-up biopsies, disease bulk may be markedly reduced and reactive lymphoid proliferation may complicate the morphological assessment. Transformation of the original lymphoma to a higher grade or the development of a new type of lymphoma may occur or the BMB may be discordant with the lymph node diagnosis. Plasma cell myeloma and related disorders must be considered in the differential diagnosis of lymphoid proliferations with plasmacytic and plasmablastic differentiation. Diffuse interstitial lymphocytosis, lymphoid aggregates, lymphoid follicles with germinal centres and reactive lymphohistiocytic infiltrates may mimic lymphomas.
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Introduction: Bone marrow aspiration and biopsies are carried out principally to permit cytological assessment of marrow. The procedure is also indicated for immunophenotypic, cytogenetic, molecular and other specialized investiga...
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Introduction: Bone marrow aspiration and biopsies are carried out principally to permit cytological assessment of marrow. The procedure is also indicated for immunophenotypic, cytogenetic, molecular and other specialized investigations. The skill to perform bone marrow aspirate and biopsy is usually acquired by the medical personnel through apprenticeship during their training. The training includes performing the procedure, indications, contraindications, and associated hazards. Moi Teaching and Referral Hospital (MTRH) being a specialized Hospital in Western Kenya has several staff trained on performing the procedure. Objective: To assess the performance of bone marrow procedure by clinicians at a teaching and referral hospital. Materials and methods: A descriptive cross-sectional study was done involving 40 clinicians working in the hematology clinic and medical wards from June to December 2019. A structured questionnaire was used to collect the data and data analysis was done using frequency tables. Approval to carry out the study was sought from the institutional IRB. Results: Patients attended to were predominantly adults 33 (83%). The superior posterior iliac crest was the commonest site for the procedure and disposable needles were routinely used in 33 (83%) of the patients. Pain and excessive bleeding 18 (45%) were the commonest complications associated with the procedure. Conclusion: Most of the clinicians involved doing the procedure were residents/registrars. Most of the patients attended to were adults (83%) and majority of the clinicians performed the procedure on the posterior iliac site (96%) using disposable needles (83%). Local anesthesia was commonly used during the procedure (88%). The common complications associated with the bone marrow procedure were pain and excessive bleeding (45%).
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With advancing age have been observed bone and bone marrow phenotypic alterations due to the impaired bone tissue homeostatic features, involving bone remodeling, and bone marrow niche ontogeny. The complex inflamm-aging pathologi...
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With advancing age have been observed bone and bone marrow phenotypic alterations due to the impaired bone tissue homeostatic features, involving bone remodeling, and bone marrow niche ontogeny. The complex inflamm-aging pathological scenario that culminates with osteopenia and mesenchymal/stromal and hematopoietic stem cell commitment breakdown, is controlled by cellular and molecular intramural components comprising adapter proteins such as the sequestosome 1 (p62/SQSTM1). p62, a multiway function protein, has been reported as an effective anti-inflammatory, bone-building factor. In this view, we considered for the first time the involvement of p62 in aging bone and bone marrow of 1 year and 2 years p62(-/-) mice. Interestingly, p62 deficiency provoked accelerated osteopenia and impaired niche operational activities within the bone marrow. The above findings unearthed the importance of p62 in mesenchymal stem cell maintenance/differentiation schedule in old animals and provide, at least in part, a mechanistic scenario of p62 action.
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Primary care providers (PCPs) must have accurate information regarding bone marrow donation to effectively educate patients. Since unrelated bone marrow donors are important sources for individuals requiring bone marrow transplant...
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Primary care providers (PCPs) must have accurate information regarding bone marrow donation to effectively educate patients. Since unrelated bone marrow donors are important sources for individuals requiring bone marrow transplant, providers must understand the donation process in order to facilitate it. How bone marrow donations are used, how to join the registry, the process of donation, and the risks and benefits of donation are described. With the increasing need for bone marrow donation, PCPs who are well-educated on this subject can guide their patients in making the potentially life-saving decision to donate.
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Recently, the Japanese Marrow Donor Program (JMDP) reported that 3 patients with transplanted hemolyzed bone marrow (BM) showed severe adverse effects related to hemolysis [1]. In these cases, each BM was collected in a hospital a...
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Recently, the Japanese Marrow Donor Program (JMDP) reported that 3 patients with transplanted hemolyzed bone marrow (BM) showed severe adverse effects related to hemolysis [1]. In these cases, each BM was collected in a hospital and then shipped to another hospital where a patient had received conditioning. BM harvest and shipping were conducted according to the JMDP manual. Collected BM was infused directly into each patient because of ABO blood type compatibility. A hemolytic reaction was suspected just after the beginning of BM infusion based on symptoms such as nausea, vomiting, and blood pressure fluctuation and signs such as hematuria and an increase in serum lactic acid dehydrogenase/(LDH) levels and total bilirubin values. Finally, hemolysis in the bags filled with collected BM was confirmed by the reddish color of the plasma in the bags. The reddish plasma was removed from the bags by centrifugation and then the treated BM was successfully again infused without adverse reactions.
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We performed a retrospective single-center analysis to investigate the diagnostic yield of bone marrow puncture in patients with liver cirrhosis and cytopenia. Liver cirrhosis patients receiving bone marrow aspiration or biopsy fo...
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We performed a retrospective single-center analysis to investigate the diagnostic yield of bone marrow puncture in patients with liver cirrhosis and cytopenia. Liver cirrhosis patients receiving bone marrow aspiration or biopsy for the diagnostic work-up of otherwise unexplained peripheral blood cytopenia at our institution between 2004 and 2020 were enrolled in this study. We evaluated findings from cytologic, histologic and immunologic assessment and final diagnostic outcomes. A total of 118 patients with a median age of 55 years and a median Child-Pugh score of B (8 points) were enrolled. The main etiologies of liver cirrhosis were viral hepatitis (B and C) or chronic alcohol consumption. The majority of patients (60%) exhibited concurrent anemia, leukocytopenia and thrombocytopenia. Bone marrow assessment revealed normal, unspecific or reactive alterations in 117 out of 118 patients (99%). One patient was diagnosed with myelodysplastic syndrome. Our findings suggest that peripheral blood cytopenia in patients with liver cirrhosis is rarely associated with a primary bone marrow pathology.
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Introduction: Bone marrow examination is an important diagnostic tool to evaluate various disorder including both neoplastic and non-neoplastic hematological diseases. The two most important techniques used for the diagnosis are b...
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Introduction: Bone marrow examination is an important diagnostic tool to evaluate various disorder including both neoplastic and non-neoplastic hematological diseases. The two most important techniques used for the diagnosis are bone marrow aspiration and bone marrow trephine biopsy which are complementary to each other. Aim and Objectives : To compare the diagnostic value of bone marrow aspiration and biopsy. Material and methods: A total of 88cases with both bone marrow aspiration and biopsy were included in the study. All the aspirate smears were routinely stained by Jenner Giemsa while the trephine biopsy sections were stained by routine Hematoxylin and Eosin stain.. All the smears and sections were reviewed and the findings on BMA and BMB were compared and the final correlation done. Result: Hypolastic marrow was the most common diagnosis followed by immune thrombocytopenic purpura (ITP). But the diagnostic accuracy of ITP on aspiration was 100 % in compare to hypoplastic marrow (81.25%). The diagnosis accuracy of BMA in our study was 84.09%. Conclusion: Bone marrow aspiration and biopsy complement each other. Bone marrow aspiration provides better study of the cell, whereas biopsy provides detail about the pattern of cellular distribution, hence when performed together it gives better diagnostic accuracy.
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Abstract Bone marrow adipocytes (BMAs) derived from mesenchymal stem cells (MSC) are an active and significant element of the bone marrow microenvironment. They are involved in metabolic functions, complex interactions with other ...
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Abstract Bone marrow adipocytes (BMAs) derived from mesenchymal stem cells (MSC) are an active and significant element of the bone marrow microenvironment. They are involved in metabolic functions, complex interactions with other stromal cells, and in the development and progression of tumours. Currently, there is little data regarding the role of BMAs in haematological malignancies. Due to this, we have attempted to characterise the BMAs in these malignancies in terms of quantity and morphology. Our study included 30 patients aged 22–76 with myelo- (n=17) and lymphoproliferative malignancies (n=13), both with and without bone marrow infiltration. Trepanobioptate was the evaluated material. The number and diameter of BMAs were measured, and the percentage of adipocytes (adipocyte fraction – AF), hematopoietic cells (hematopoietic fraction – HF) and trabecular bone (trabecular bone fraction – BF) was calculated. The obtained results were considered against the clinical parameters of age, sex, body weight, body surface area (BSA) and body mass index (BMI). We observed that as age increases, the number of BMA/mm 2 , the diameter of adipocytes and AF increase while BF and HF decrease. However, this relationship was not statistically significant. A significant correlation of BMA parameters was also not found in relation to weight, BMI and BSA, and the number and diameter of BMAs were comparable in both sexes. The trepanobioptate of infiltrated bone marrow showed a decreased number of BMA/mm 2 compared to the trepanobioptate from bone marrow without infiltration (97.44±69.16 vs. 164.14±54.16; p=0.010) with a marked difference in men (69.75±65.26 vs. 180.33±60.40; p=0.007). These trepanobioptate also showed an increase in the number of BMA/mm 2 with age (r=0.472; p=0.041), and with an increase of BMI, an increase in diameter of BMAs (r=0.625; p=0.007) and AF (r=0.546; p=0.023). The number and size of BMAs, as well as AF, BF and HF in patients with myeloproliferative malignancies did not differ significantly compared to patients with lymphoproliferative malignancies.
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