How to read the results of bone marrow aspiration
Bone marrow puncture is one of the important methods for diagnosing blood system diseases. Cytology, pathology and molecular biology analysis of bone marrow samples can help doctors determine the patient's hematopoietic function, disease type and prognosis. This article will combine recent hot medical topics with a structured interpretation of common indicators in bone marrow aspiration reports and their clinical significance.
1. The relationship between recent hot medical topics and bone marrow aspiration
| hot topics | Related content | time |
|---|---|---|
| New progress in early screening of leukemia | Application of bone marrow aspiration in the detection of minimal residual disease | 2023-11-05 |
| Updated guidelines for diagnosis and treatment of aplastic anemia | Revision of the grading standard for bone marrow hyperplasia | 2023-11-08 |
| Expansion of indications for CAR-T cell therapy | The key role of bone marrow aspiration in efficacy evaluation | 2023-11-12 |
2. Interpretation of core indicators of bone marrow puncture
| Indicator category | normal reference value | abnormal meaning |
|---|---|---|
| degree of bone marrow hyperplasia | Active proliferation (Grade II) | Grade I (reduced) indicates aplastic disorder; grade III (obviously active) is seen in leukemia. |
| Grain red ratio | 2-4:1 | Increased in infections/leukemia; decreased in iron deficiency anemia |
| primitive cell ratio | <5% | ≥20% is the diagnostic criteria for acute leukemia |
| megakaryocyte count | 7-35 pieces/piece | Decreased in ITP; increased in myeloproliferative disorders |
3. Comparison of bone marrow imaging characteristics of common diseases
| disease type | bone marrow hyperplasia | cell morphology | special performance |
|---|---|---|---|
| iron deficiency anemia | active | Red blood cell hyperplasia and delayed cytoplasmic development | Circular sideroblastopenia |
| acute myeloid leukemia | Extremely active | Primitive cells ≥20% | Auer corpuscle (M3 type) |
| multiple myeloma | active | Plasma cells＞10% | Russell bodies |
4. Things to note when interpreting the report
1.Combined with clinical manifestations:Bone marrow puncture results need to be judged comprehensively with blood routine, symptoms and signs. Abnormalities in a single indicator may have no pathological significance.
2.Dynamic observation:Certain hematological diseases require multiple punctures for comparison, such as monitoring the progression of myelodysplastic syndrome (MDS).
3.Special dyeing meaning:Iron staining (to determine iron deficiency), PAS staining (to identify erythroleukemia), and NAP score (to differentiate between chronic myeloid and leukemia-like reactions).
5. Answers to frequently asked questions by patients
| question | Professional answers |
|---|---|
| Is reduced bone marrow hyperplasia leukemia? | Not necessarily, aplastic anemia, radiation damage, etc. can all cause |
| What does "sick hematopoiesis" mean in the report? | It indicates the possibility of myelodysplastic syndrome (MDS) and further examination is required. |
| Why is immunophenotyping necessary? | Can accurately determine the source of leukemia cells (such as B cell line/T cell line) |
Conclusion:Interpretation of bone marrow aspiration results requires comprehensive analysis by a professional hematologist. The recently updated expert consensus in the "Chinese Journal of Hematology" emphasizes that a comprehensive diagnostic model of bone marrow morphology-immunity-cytogenetics-molecular biology (MICM) should be established. If any abnormality is found in the report, it is recommended to bring complete information to a specialist clinic for further evaluation.
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