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 |
| _version_ | 1819267858406834176 |
|---|---|
| author | Adrian R. Bersabe James K. Aden Nathan M. Shumway Michael B. Osswald |
| author_facet | Adrian R. Bersabe James K. Aden Nathan M. Shumway Michael B. Osswald |
| author_sort | Adrian R. Bersabe |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-23T21:23:51Z |
| format | Article |
| id | doaj.art-7f25138aaaf84b0089ac0489ee0dce0e |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-12-23T21:23:51Z |
| publishDate | 2017-06-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-7f25138aaaf84b0089ac0489ee0dce0e2022-12-21T17:30:40ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2017-06-01116JC01JC0310.7860/JCDR/2017/24506.9979Peripheral Smear Review and Bone Marrow Biopsy CorrelationAdrian R. Bersabe0James K. Aden1Nathan M. Shumway2Michael B. Osswald3Fellow, Department of Internal Medicine: Hematology/Oncology, San Antonio Military Medical Centre, Fort Sam Houston, Texas, USA.Statistician, Institute of Surgical Research, San Antonio Military Medical Centre, Fort Sam Houston, Texas, USA.Staff Physician, Private Practice in Oncology, San Antonio, Texas, USA.Staff Physician, Department of Internal Medicine: Hematology/Oncology, San Antonio Military Medical Centre, Fort Sam Houston, Texas, USA.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.https://jcdr.net/articles/PDF/9979/24506_CE(RA1)_F(T)_PF1(RB_SS)_PFA(RB_SS).pdfblood plateletserythrocyteleukocyteperipheral blood |
| spellingShingle | Adrian R. Bersabe James K. Aden Nathan M. Shumway Michael B. Osswald Peripheral Smear Review and Bone Marrow Biopsy Correlation Journal of Clinical and Diagnostic Research blood platelets erythrocyte leukocyte peripheral blood |
| title | Peripheral Smear Review and Bone Marrow Biopsy Correlation |
| title_full | Peripheral Smear Review and Bone Marrow Biopsy Correlation |
| title_fullStr | Peripheral Smear Review and Bone Marrow Biopsy Correlation |
| title_full_unstemmed | Peripheral Smear Review and Bone Marrow Biopsy Correlation |
| title_short | Peripheral Smear Review and Bone Marrow Biopsy Correlation |
| title_sort | peripheral smear review and bone marrow biopsy correlation |
| topic | blood platelets erythrocyte leukocyte peripheral blood |
| url | https://jcdr.net/articles/PDF/9979/24506_CE(RA1)_F(T)_PF1(RB_SS)_PFA(RB_SS).pdf |
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