Are Peripheral Blood Counts Predictor of Bone Marrow Infiltration and Hypocellularity in Malignant Neoplasms?

To determine the association of peripheral blood counts (cytopenia and normal counts) with bone marrow findings in patients with malignant neoplasms.

Descriptive study. Place and Duration of the Study: King Edward Medical University from 2017 to 2019.

Patients having malignant diseases, of both gender and all ages, were included. Clinical data and results of bilateral bone marrow aspiration and biopsy were noted.  Results were categorised as groups with bone marrow infiltration, normal morphology with normal cellularity and normal morphology with decreased cellularity. Results were analysed using SPSS V21 applying Chi-square test, keeping the confidence interval 95% and p-value of <0.05 as significant.

A total of 157 patients were included (107 men, 50 women). The main categories of neoplasm included non-Hodgkin's lymphoma [93 (59.2%)] Hodgkin's lymphoma [31 (19.7%)], and solid organ malignancy [33 (21.0%]. Bone marrow infiltration was seen in 50 (31.8%) patients, normal morphology with decreased cellularity in 51 (32.5%) and normal morphology with normal cellularity in 56 (35.7%) patients. Cytopenias were seen in 88 (56.1%) patients (out of these 28 (31.8%) had bone marrow infiltrarion, 32 (36.4%) had decreased cellularity and 28 (31.8%) with normal cellularity). In 69 (43.9%) patients with normal CBC, 22 (31.9%) had infiltration, 19 (27.5%) had decreased cellularity and 28 (40.6%) had normal cellularity. No association of cytopenia with bone marrow results was obtained (p = 0.086).

Bone marrow infiltration and hypocellularity are not reflected by peripheral blood counts. Therefore, bone marrow biopsy remains decisive in patients with malignant neoplasm for disease staging and selection of treatment options. Key Words: Peripheral blood counts, Bone marrow infiltration, malignant neoplasms, bone marrow hypocellularity.