Trends in bone marrow sampling and core biopsy specimen adequacy in the United States and Canada: A multicenter study

Mihai Merzianu, Adrienne Groman, Alan Hutson, Claudiu Cotta, Russell K. Brynes, Attilio Orazi, Vishnu Reddy, Julie Teruya-Feldstein, Ramila Amre, Manjula Balasubramanian, Guilherme Brandao, Sindhu Cherian, Elizabeth Courville, David Czuchlewski, Guang Fan, David Grier, Daniela Hoehn, Kedar V. Inamdar, Ridas Juskevicius, Prabhjot KaurJohn Lazarchick, Michael R. Lewis, Rodney R. Miles, Jerome B. Myers, Michel R. Nasr, Hina N. Qureishi, Horatiu Olteanu, Valentin G. Robu, Gratian Salaru, Neerja Vajpayee, Jeffrey Vos, Ling Zhang, Shanxiang Zhang, Le Aye, Elisa Brega, James E. Coad, John Grantham, Sinisa Ivelja, Robert McKenna, Kieran Sultan, Gregory Wilding, Robert Hutchison, Loann Peterson, Richard T. Cheney

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Objectives: To assess bone marrow (BM) sampling in academic medical centers. Methods: Data from 6,374 BM samples obtained in 32 centers in 2001 and 2011, including core length (CL), were analyzed. Results: BM included a biopsy (BMB; 93%) specimen, aspirate (BMA; 92%) specimen, or both (83%). The median (SD) CL was 12 (8.5) mm, and evaluable marrow was 9 (7.6) mm. Tissue contraction due to processing was 15%. BMB specimens were longer in adults younger than 60 years, men, and bilateral, staging, and baseline samples. Only 4% of BMB and 2% of BMB/BMA samples were deemed inadequate for diagnosis. BM for plasma cell dyscrasias, nonphysician operators, and ancillary studies usage increased, while bilateral sampling decreased over the decade. BM-related quality assurance programs are infrequent. Conclusions: CL is shorter than recommended and varies with patient age and sex, clinical circumstances, and center experience. While pathologists render diagnoses on most cases irrespective of CL, BMB yield improvement is desirable.

Original languageEnglish (US)
Pages (from-to)393-405
Number of pages13
JournalAmerican journal of clinical pathology
Issue number5
StatePublished - Oct 1 2018

Bibliographical note

Funding Information:
Acknowledgments: We thank Vishala Neppalli, MD, and George Deeb, MD, for their contributions to study design, validation set testing, and data collection; Ashley Sedelmeyer, MHA, Andrea Bruno, AA, and Camille Wicher, PhD, Esq, MSN, RN, for their contribution during protocol development, center enrollment, and coordination; Mathew B. Thompsen, MPH, for assistance with data collection; Mukund Seshadri, DDS, PhD, for technical assistance; and Seema Bhat, MD, L. Jeffrey Medeiros, MD, Philip McCarthy, MD, and Eunice Wang, MD, for review of the manuscript. This work was supported by Roswell Park Comprehensive Cancer Center and National Cancer Institute (grant P30CA016056). This work was presented in part as poster presentations at the American Society of Hematology annual meeting, San Francisco, CA, 2014; and at the United States and Canadian Academy of Pathology annual meeting, Seattle, WA, 2016.

Publisher Copyright:
© 2018 American Society for Clinical Pathology. All rights reserved.


  • Bone marrow adequacy
  • Bone marrow biopsy
  • Bone marrow biopsy indications
  • Bone marrow quality
  • Core biopsy length


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