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Determination of age-dependent bone marrow normocellularity.

Jerry Wong1, Ryan Jackson2, Lu Chen2

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Bone marrow cellularity declines slowly with age, approximately 3% per decade in adults. New age-specific ranges are recommended, especially for older adults, improving diagnostic accuracy.

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Area of Science:

  • Hematology
  • Gerontology
  • Biostatistics

Background:

  • Bone marrow cellularity assessment is crucial for evaluating hematopoietic status.
  • Traditional semiquantitative estimation has limitations, particularly in older adults.
  • Existing age-adjusted normocellularity ranges lack sufficient characterization, especially for individuals over 70.

Purpose of the Study:

  • To establish a more accurate normal range for bone marrow cellularity in adults.
  • To specifically characterize age-adjusted normocellularity in older adult populations.
  • To refine understanding of bone marrow cellularity decline with aging.

Main Methods:

  • Analysis of 570 bone marrow samples from healthy donors and staging patients aged 1 to 93.
  • Utilized linear regression modeling to assess cellularity trends across age groups.
  • Determined 90% reference intervals for normocellularity.

Main Results:

  • Bone marrow cellularity in adults declines by approximately 3% per decade, continuing after age 70.
  • The 90% reference interval for normocellularity in US adults (18-90 years) is 30% to 75%.
  • A slower, more stable decline was observed compared to the traditional '100% minus age' model.

Conclusions:

  • Age-specific modeling of normocellularity is more accurate than a single linear decline.
  • Recommended ranges: <20 yrs (45-85%), 20-40 yrs (40-70%), 40-60 yrs (35-65%), >60 yrs (30-60%).
  • Individuals over 70 show no significant cellularity decrease compared to those aged 60-69.