Analysis Of Bone Marrow Aspirates And Biopsies Of 35 Myelodysplastic Syndromes

BackgroundMyelodysplastic syndromes cover a heterogeneous group of the haematopoietic stem cells, predisposing the individual to the development of AML, characterized by cytopenia and bone marrow dysfunction. The diagnosis is usually made on the basis of quantitative abnormalities of the three haematopoeitic cell lines in the peripheral blood and qualitative abnormalities in the bone marrow.In a retrospective follow-up study from 1995-2005, bone marrow aspirates and biopsies of 35 patients with MDS were investigate, to find whether it is possible to make the diagnosis of MDS on the basis of bone marrow biopsies and to find how to enable a more reliable and accurate diagnosis of MDS.1. Patients and methords1.1 Diagnosis and classification of MDS:according to French-American-British (FAB) scheme1.2 PatientsIn a retrospective follow-up study from 1995~2005, bone marrow aspirates and biopsies of 35 patients with MDS were investigated. Male / female was about 1.2: 1. Median age was 54 ± 13.1.3 MethordsSections of plastic embedded biopsies and smears of bone marrow aspirates of 35 MDS patients were stained according to Giemsa. Biopsies of bone marrow of 19 patients were stained according to Gomori. All of the pieces was examined by electron microscopy.2. ResultsIn 74% of our 35 cases of MDS the smears of bone marrow aspirates showed MDS, compared with 57% of bone marrow biopsies of our patients. (P>0.05 ) The presence of dyserythropoiesis in smears of bone marrow aspirates in 51% patients, compared with bone marrow biopsies in 26% cases. ( P<0.05 )According to the cellularity of bone marrow biopsies, about 77% of our patients showed normocellular or hypercellular ( more than 35 vol% haematopoiesis ). In 19 patients with MDS , 13 cases ( 68% ) revealed fibrous reticulum in bone marrow biopsies. One patient was diagnosed as MDS-RA with myelofibrosis.3. ConclusionsZhangzhinan or FAB diagnosis and classification of MDS were based on morphological change of haematopoietic cells, which was based mainly on smears. Cellular abnormalities, architectural anarch and stromal changes are reflected more accurately in bone marrow sections of biopsies than smears of aspirates. It is possible to make the diagnosis ofMDS on the basis of bone marrow biopsies. Many diagnosis pitfalls maybe excluded when both bone marrow aspiates and biopsies are evaluated.