Flow Cytometric Analysis of Mechanically Disaggregated Bone Marrow Trephine Biopsies

Area of Science:

• Hematopathology
• Clinical Cytometry
• Flow Cytometry

Background:

• Bone marrow (BM) aspirate analysis via flow cytometry (FC) is crucial for hematologic diagnosis.
• Dry taps during BM aspiration can impede diagnostic accuracy.
• Mechanical disaggregation of BM trephine biopsies offers an alternative for FC analysis.

Purpose of the Study:

• To evaluate the utility and limitations of mechanically disaggregating BM trephine biopsies for FC.
• To assess cell yield, diagnostic findings, and turnaround time for trephine FC.
• To compare trephine FC results with aspirate FC and immunohistochemistry (IHC).

Main Methods:

• Mechanically disaggregated 80 BM trephine samples between 2010 and 2016.
• Recorded cell yield, pathological findings, and turnaround time.
• Compared trephine FC results with aspirate FC and IHC where available.

Main Results:

• Mechanical disaggregation yielded cellular samples in 98% of cases (median 3 × 10^6 cells).
• Common diagnoses included B cell lymphoproliferative disorders and acute leukemia.
• Trephine FC showed high correlation with histochemistry but could underestimate disease burden and miss some infiltrates compared to IHC.

Conclusions:

• Mechanical disaggregation of BM trephine biopsies provides a viable method for FC analysis.
• Trephine FC is a useful adjunct to trephine IHC, especially after failed aspirates.
• This technique offers rapid diagnostic immunophenotyping, improving turnaround time.