Enhancing Diagnostic Precision in Malignant Hematological Disorders Through Risk Factor Analysis for High-Quality...

Previous evidence suggests that the diagnostic role of bone marrow aspiration (BMA) is altered by the hematological malignancy itself, thereby reducing its diagnostic accuracy and potentially delaying patient care. This association, however, remains largely unevaluated.

We used a multivariable logistic regression model to estimate the association between hematological malignancies and the quality of the BMA, defined as optimal or suboptimal. Our primary outcome evaluated the association between hematological condition type and the quality of the bone marrow aspirate. Our secondary outcomes were to determine laboratory and patient-specific risk factors associated with the quality of the bone marrow aspirate.

We analyzed a total of 875 patients who had either acute myeloid leukemia (AML), myelodysplastic syndrome (MDS), multiple myeloma (MM), or non-Hodgkin lymphoma (NHL). We found that patients with AML and MDS were associated with a suboptimal BMA (OR 0.72; 95% CI 0.56-0.91 and OR 0.63; 95% CI 0.50-0.79, respectively). We also found that in patients with AML and MDS, age was associated with a suboptimal BMA (OR 0.63; 95% CI 0.49-0.81 and OR 0.72; 95% CI 0.53-0.97), whereas high levels of hemoglobin (OR 2.56; 95% CI 2.07-2.98 and OR 1.16; 95% CI 1.02-1.35), and platelets (OR 1.27; 95% CI 1.07-1.44 and OR 1.34; 95% CI 1.11-1.49) were associated with an optimal BMA.

We found that in AML and MDS, factors such as advanced age, low levels of hemoglobin, platelets, and white blood cells are associated with the quality of the BMA, thereby impacting its diagnostic accuracy.