Category
Hematology
Sub Category
Cytology
Synonyms/Aliases
N/A
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
Complete history with relevant investigations including recent CBC and concurrent peripheral blood film examination
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
N/A
Sample type
Properly prepared, labeled, air dried, fixed smears required. slides should be labeled with 2 patient identifiers, including name. if slides are not fixed, label as unfixed. if fixation is done, this should be with freshly prepared methanol.
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)
Rejection criteria
Labeling issue (unlabeled/ mislabeled); missing request form; wrong sample type; broken slides
Other Instructions
if additional tests are required, obtain the relevant samples & list them on the request form e.g. flow Cytometry (EDTA & Heparin Vacutainer, 3ml each), Cytogenetics (Sodium Heparin Vacutainer), Culture (Blood Culture Bottles) etc.
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.