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 Kaur; John 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

doi:10.1093/ajcp/aqy066

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

Laboratory Medicine and Pathology

Research output: Contribution to journal › Article › peer-review

6 Scopus citations

Abstract

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 language	English (US)
Pages (from-to)	393-405
Number of pages	13
Journal	American journal of clinical pathology
Volume	150
Issue number	5
DOIs	https://doi.org/10.1093/ajcp/aqy066
State	Published - 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.

Keywords

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

Publisher link

10.1093/ajcp/aqy066

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6166687

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Merzianu, M., Groman, A., Hutson, A., Cotta, C., Brynes, R. K., Orazi, A., Reddy, V., Teruya-Feldstein, J., Amre, R., Balasubramanian, M., Brandao, G., Cherian, S., Courville, E., Czuchlewski, D., Fan, G., Grier, D., Hoehn, D., Inamdar, K. V., Juskevicius, R., ... Cheney, R. T. (2018). Trends in bone marrow sampling and core biopsy specimen adequacy in the United States and Canada: A multicenter study. American journal of clinical pathology, 150(5), 393-405. https://doi.org/10.1093/ajcp/aqy066

Merzianu, M, Groman, A, Hutson, A, Cotta, C, Brynes, RK, Orazi, A, Reddy, V, Teruya-Feldstein, J, Amre, R, Balasubramanian, M, Brandao, G, Cherian, S, Courville, E, Czuchlewski, D, Fan, G, Grier, D, Hoehn, D, Inamdar, KV, Juskevicius, R, Kaur, P, Lazarchick, J, Lewis, MR, Miles, RR, Myers, JB, Nasr, MR, Qureishi, HN, Olteanu, H, Robu, VG, Salaru, G, Vajpayee, N, Vos, J, Zhang, L, Zhang, S, Aye, L, Brega, E, Coad, JE, Grantham, J, Ivelja, S, McKenna, R, Sultan, K, Wilding, G, Hutchison, R, Peterson, L & Cheney, RT 2018, 'Trends in bone marrow sampling and core biopsy specimen adequacy in the United States and Canada: A multicenter study', American journal of clinical pathology, vol. 150, no. 5, pp. 393-405. https://doi.org/10.1093/ajcp/aqy066

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

abstract = "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.",

keywords = "Bone marrow adequacy, Bone marrow biopsy, Bone marrow biopsy indications, Bone marrow quality, Core biopsy length",

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

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: {\textcopyright} 2018 American Society for Clinical Pathology. All rights reserved.",

year = "2018",

month = oct,

day = "1",

doi = "10.1093/ajcp/aqy066",

language = "English (US)",

volume = "150",

pages = "393--405",

journal = "American journal of clinical pathology",

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publisher = "American Society of Clinical Pathologists",

number = "5",

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TY - JOUR

T1 - Trends in bone marrow sampling and core biopsy specimen adequacy in the United States and Canada

T2 - A multicenter study

AU - Merzianu, Mihai

AU - Groman, Adrienne

AU - Hutson, Alan

AU - Cotta, Claudiu

AU - Brynes, Russell K.

AU - Orazi, Attilio

AU - Reddy, Vishnu

AU - Teruya-Feldstein, Julie

AU - Amre, Ramila

AU - Balasubramanian, Manjula

AU - Brandao, Guilherme

AU - Cherian, Sindhu

AU - Courville, Elizabeth

AU - Czuchlewski, David

AU - Fan, Guang

AU - Grier, David

AU - Hoehn, Daniela

AU - Inamdar, Kedar V.

AU - Juskevicius, Ridas

AU - Kaur, Prabhjot

AU - Lazarchick, John

AU - Lewis, Michael R.

AU - Miles, Rodney R.

AU - Myers, Jerome B.

AU - Nasr, Michel R.

AU - Qureishi, Hina N.

AU - Olteanu, Horatiu

AU - Robu, Valentin G.

AU - Salaru, Gratian

AU - Vajpayee, Neerja

AU - Vos, Jeffrey

AU - Zhang, Ling

AU - Zhang, Shanxiang

AU - Aye, Le

AU - Brega, Elisa

AU - Coad, James E.

AU - Grantham, John

AU - Ivelja, Sinisa

AU - McKenna, Robert

AU - Sultan, Kieran

AU - Wilding, Gregory

AU - Hutchison, Robert

AU - Peterson, Loann

AU - Cheney, Richard T.

N1 - 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.

PY - 2018/10/1

Y1 - 2018/10/1

N2 - 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.

AB - 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.

KW - Bone marrow adequacy

KW - Bone marrow biopsy

KW - Bone marrow biopsy indications

KW - Bone marrow quality

KW - Core biopsy length

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DO - 10.1093/ajcp/aqy066

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JO - American journal of clinical pathology

JF - American journal of clinical pathology

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ER -

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

Abstract

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Keywords

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