Category
Hematology
Sub Category
Cytology
Synonyms/Aliases
Bone Marrow Aspirate
Abbreviations
BMA, BMAC
Type
Individual Test
3-5 days
Results ready in 3-5 working days
Method
Staining & microscopy
Temp
Room temperature (slides)
Setup
All working days
Components/ Parameters
N/A : However concurrent CBC/ PBF ordering is required.
Pre-analytic Considerations
N/A
Test Ordering Instructions
Fill out test request form fully & legibly. Clinical history/ indications required inclusive of results of other diagnostic work-up. concurrent CBC printout or CBC order required. concurrent PBF order/ examination required for optimal hematological assessment.
Patient preparation
Booking for the procedure is required. Children usually require sedation/ anesthesia therefore should be in fasting status at the time of the procedure. charges for sedation/ anesthesia are additional.
Sample type
Properly prepared, labeled, air dried, fixed smears required.
Container/ preservative
Slides should be prepared directly. bone marrow sample can be transferred into EDTA (purple top) vacutainer but slides must then be prepared within 1-2 hours of collection.
Sample volume
N/A (slides required; however for cytology, do not draw >0.5ml for slide preparation to avoid Hemodilution; if additional tests e.g. flow Cytometry, Cytogenetics, culture are required, further draws can be done)
Rejection criteria
Labeling issue (unlabeled/ mislabeled); missing request form; wrong sample type; broken slides
Other Instructions
N/A
Reference intervals
Negative for disease/ malignancy
Clinical Utility
Variable E.g. Assess Unexplained Cytopenias (Anemia, Leukopenia, Thrombocytopenia), Unexplained Cytoses (Polycythemia, Leukocytosis, Thrombocytosis), Suspected Malignancy Or Infiltration (Leukemia, Lymphoma, Myeloproliferative Neoplasms, Metastatic Disease), Pyrexia Of Unknown Origin, Infectious Diseases (E.g. Leishmaniasis), B Symptoms (Unintentional Weight Loss, Drenching Night Sweats, Fever) Etc.
Test Limitations/ Confounders
Poor slide preparation / fixation can compromise interpretation/ make BMA unreportable; some diseases e.g. multiple myeloma may involve the bone marrow in a patchy fashion therefore sampling bias may lead to false negative results; optimal bone marrow assessment frequently requires concurrent trephine biopsy to be obtained; some diagnoses can only be made on histology (trephine biopsy) samples e.g. Aplastic anemia, when dry or aparticulate aspirates are obtained.