Peripheral Smear Review and Bone Marrow Biopsy Correlation
Introduction: Peripheral Blood Smear (PBS) interpretation is a useful skill for Haematology/Oncology Clinicians (HOC). Aim: To explore practice patterns of PBS utilization for all benign haematology diagnosis in a non-simulated environment and to evaluate how it may guide the HOC in determining...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2017-06-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/9979/24506_CE(RA1)_F(T)_PF1(RB_SS)_PFA(RB_SS).pdf |
| Summary: | Introduction: Peripheral Blood Smear (PBS) interpretation is a
useful skill for Haematology/Oncology Clinicians (HOC).
Aim: To explore practice patterns of PBS utilization for all benign
haematology diagnosis in a non-simulated environment and
to evaluate how it may guide the HOC in determining further
work up and whether or not to perform a Bone Marrow Biopsy
(BMB).
Materials and Methods: A retrospective review was conducted
on 451 outpatient referrals for benign haematology diagnosis.
Patient demographics and diagnostic tests were recorded. We
further analysed cases in which a blood smear was ordered
or reviewed. In cases with PBS review, we recorded testing
ordered by the HOC.
Results: Records of 451 patients met inclusion criteria. The
median age was 55 with males representing 51.9% of the cohort.
Distribution of disorders were 50.6% (n = 228) erythrocyte (RBC),
25.5% (n = 114) leukocyte (WBC), 11.3% (n = 51) platelet (PLT),
and 12.8% (n = 58) “other.” A CBC was ordered in 82.7% of
cases (373/451). A PBS was ordered in 47.4% of CBCs obtained
(177/373, p<0.001). Of these, documentation occurred in 49.2%
(87/177) which led to further testing 41.4% of cases (36/87). A
BMB was performed in 11.5% (10/87) of cases in which a PBS
was reviewed compared to 4.3% (16/373) of cases where BMB
was performed without PBS review (p=.019).
Of the 36 cases in which PBS review led to testing, 10 BMBs
(27.8%) were performed—all of which led to specific haematologic diagnosis. A specific diagnosis was found in 43.8%
(7/16) BMBs performed without prior PBS review.
Conclusion: PBS interpretation is an important skill for HOCs.
Haematology/Oncology (H/O) training programs should continue
to teach this skill to increase proficiency in order to help guide
diagnostic evaluation of various haematologic disorders. |
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| ISSN: | 2249-782X 0973-709X |